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Table of Contents
Vol. 221, No. 5, 2007
Issue release date: August 2007
Ophthalmologica 2007;221:282–291

Ocular Photodynamic Therapy – Standard Applications and New Indications (Part 2)

Review of the Literature and Personal Experience

Mennel S. · Barbazetto I. · Meyer C.H. · Peter S. · Stur M.
aDepartment of Ophthalmology, Philipps University, Marburg, and bDepartment of Ophthalmology, University of Bonn, Bonn, Germany; cE.S. Harkness Eye Institute, Columbia Presbyterian Hospital, New York, N.Y., USA; dDepartment of Ophthalmology, Academic Hospital, Feldkirch, and eDepartment of Ophthalmology, Medical University of Vienna, Vienna, Austria

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Photodynamic therapy (PDT) has become a well-established treatment for vascular forms of age-related macular degeneration (AMD). The implementation of evidence-based medicine principles into the treatment regimen of AMD seems to be immensly important, since AMD continues to be the most frequent cause of blindness among patients older than 65 years in industrialized countries. Numerous randomized prospective studies demonstrated high levels of evidence for the efficacy of various treatment approaches such as laser photocoagulation, PDT, subretinal surgery or novel anti-angiogenic drugs [Arch Ophthalmol 2006;124:597–599]. The high evidence shown by these studies supported the rationale to use PDT also in additional, less frequent, vasoproliferative diseases. Although these ‘case series’ and ‘individual case control studies’ have a low level of evidence, they give us important information for treatment decisions in these rare conditions. The goal of this survey is to review the current literature regarding PDT in vasoproliferative and exudative ocular diseases outside AMD. Many studies modified the treatment parameters of PDT to address the specific pathology of the underlying disease. Table 1 summarizes the diseases and treatment parameters that are described in this part 2, the entire table of this review is included in part 1 ( 000101922).

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  1. Mennel S, Hausmann N, Meyer CH, Peter S: Photodynamic therapy for exudative hamartoma in tuberous sclerosis. Arch Ophthalmol 2006;124:597–599.
  2. Barbazetto I, Schmidt-Erfurth U: Photodynamic therapy of choroidal hemangioma: two case reports. Graefes Arch Clin Exp Ophthalmol 2000;238:214–221.
  3. Madreperla SA: Choroidal hemangioma treated with photodynamic therapy using verteporfin. Arch Ophthalmol 2001;119:1606–1610.
  4. Michels S, Michels R, Beckendorf A, Schmidt-Erfurth U: Photodynamic therapy for choroidal hemangioma: long-term results. Ophthalmologe 2004;101:569–575.
  5. Michels S, Michels R, Simader C, Schmidt-Erfurth U: Verteporfin therapy for choroidal hemangioma: a long-term follow-up. Retina 2005;25:697–703.
  6. Schmidt-Erfurth UM, Michels S, Kusserow C, Jurklies B, Augustin AJ: Photodynamic therapy for symptomatic choroidal hemangioma: visual and anatomic results. Ophthalmology 2002;109:2284–2294.
  7. Gupta M, Singh AD, Rundle PA, Rennie IG: Efficacy of photodynamic therapy in circumscribed choroidal haemangioma. Eye 2004;18:139–142.
  8. Jurklies B, Anastassiou G, Ortmans S, Schuler A, Schilling H, Schmidt-Erfurth U, Bornfeld N: Photodynamic therapy using verteporfin in circumscribed choroidal haemangioma. Br J Ophthalmol 2003;87:84–89.
  9. Robertson DM: Photodynamic therapy for choroidal hemangioma associated with serous retinal detachment. Arch Ophthalmol 2002;120:1155–1161.
  10. Singh AD, Kaiser PK, Sears JE, Gupta M, Rundle PA, Rennie IG: Photodynamic therapy of circumscribed choroidal haemangioma. Br J Ophthalmol 2004;88:1414–1418.
  11. Porrini G, Giovannini A, Amato G, Ioni A, Pantanetti M: Photodynamic therapy of circumscribed choroidal hemangioma. Ophthalmology 2003;110:674–680.
  12. Verbraak FD, Schlingemann RO, Keunen JE, de Smet MD: Longstanding symptomatic choroidal hemangioma managed with limited PDT as initial or salvage therapy. Graefes Arch Clin Exp Ophthalmol 2003;241:891–898.
  13. Huiskamp EA, Muskens RP, Ballast A, Hooymans JM: Diffuse choroidal haemangioma in Sturge-Weber syndrome treated with photodynamic therapy under general anaesthesia. Graefes Arch Clin Exp Ophthalmol 2005;243:727–730.
  14. Bains HS, Cirino AC, Ticho BH, Jampol LM: Photodynamic therapy using verteporfin for a diffuse choroidal hemangioma in Sturge-Weber syndrome. Retina 2004;24:152–155.
  15. Shields JA: Photodynamic therapy for choroidal hemangioma. Graefes Arch Clin Exp Ophthalmol 2006;244:1071–1072.
  16. Jurklies B, Bornfeld N: The role of photodynamic therapy in the treatment of symptomatic choroidal hemangioma. Graefes Arch Clin Exp Ophthalmol 2005;243:393–396.
  17. Vicuna-Kojchen J, Banin E, Averbukh E, Barzel I, Shulman M, Hemo I, Pe’er J, Chowers I: Application of the standard photodynamic treatment protocol for symptomatic circumscribed choroidal hemangioma. Ophthalmologica 2006;220:351–355.
  18. Webster AR, Maher ER, Moore AT: Clinical characteristics of ocular angiomatosis in von Hippel-Lindau disease and correlation with germline mutation. Arch Ophthalmol 1999;117:371–378.
  19. Atebara NH: Retinal capillary hemangioma treated with verteporfin photodynamic therapy. Am J Ophthalmol 2002;134:788–790.
  20. Javellana JA, Drouilhet JH, Kokame GT, Chee PH, Wong BM: Retinal capillary angioma in familial exudative vitreoretinopathy treated with photodynamic therapy. Am J Ophthalmol 2004;137:780–782.
  21. Costa RA, Meirelles RL, Cardillo JA, Abrantes ML, Farah ME: Retinal capillary hemangioma treatment by indocyanine green-mediated photothrombosis. Am J Ophthalmol 2003;135:395–398.
  22. Schmidt-Erfurth UM, Kusserow C, Barbazetto IA, Laqua H: Benefits and complications of photodynamic therapy of papillary capillary hemangiomas. Ophthalmology 2002;109:1256–1266.
  23. Obana A, Goto Y, Ikoma M: A case of von Hippel-Lindau disease with papillary capillary hemangioma treated by photodynamic therapy. Nippon Ganka Gakkai Zasshi 2004;108:226–232.

    External Resources

  24. Aaberg TM Jr, Aaberg TM Sr, Martin DF, Gilman JP, Myles R: Three cases of large retinal capillary hemangiomas treated with verteporfin and photodynamic therapy. Arch Ophthalmol 2005;123:328–332.
  25. Szabo A, Gehl Z, Seres A: Photodynamic (verteporfin) therapy for retinal capillary haemangioma, with monitoring of feeder and draining blood vessel diameters. Acta Ophthalmol Scand 2005;83:512–513
  26. Golshevsky JR, O’Day J: Photodynamic therapy in the management of juxtapapillary capillary haemangiomas. Graefes Arch Clin Exp Ophthalmol 2005;33:509–512.
  27. Gass JD, Braunstein R: Sessile and exophytic capillary angiomas of the juxtapapillary retina and optic nerve head. Arch Ophthalmol 1980;98:1790–1797.
  28. Barbazetto IA, Lee TC, Rollins IS, Chang S, Abramson DH: Treatment of choroidal melanoma using photodynamic therapy. Am J Ophthalmol 2003;135:898–899.
  29. Wachtlin J, Bechrakis NE, Foerster MH: Photodynamic therapy with verteporfin for uveal melanoma: a clinical histopathological pilot study. Ophthalmologe 2005;102:241–246.
  30. Rodriguez-Coleman H, Spaide RF, Yannuzzi LA: Treatment of angiomatous lesions of the retina with photodynamic therapy. Retina 2002;22:228–232.
  31. Barbazetto IA, Smith RT: Vasoproliferative tumor of the retina treated with PDT. Retina 2003;23:565–567.
  32. Barbazetto IA, Lee TC, Abramson DH: Treatment of conjunctival squamous cell carcinoma with photodynamic therapy. Am J Ophthalmol 2004;138:183–189.
  33. Rossi R, Puccioni M, Mavilia L, Campolmi P, Mori M, Cappuccini A, Reali EF, Cappugi P: Squamous cell carcinoma of the eyelid treated with photodynamic therapy. J Chemother 2004;16:306–309.
  34. Piccolino FC, Borgia L: Central serous chorioretinopathy and indocyanine green angiography. Retina 1994;14:231–242.
  35. Guyer DR, Yannuzzi LA, Slakter JS, Sorenson JA, Ho A, Orlock D: Digital indocyanine green videoangiography of central serous chorioretinopathy. Arch Ophthalmol 1994;112:1057–1062.
  36. Spaide RF, Hall L, Haas A, Campeas L, Yannuzzi LA, Fisher YL, Guyer DR, Slakter JS, Sorenson JA, Orlock DA: Indocyanine green videoangiography of older patients with central serous chorioretinopathy. Retina 1996;16:203–213.
  37. Yannuzzi LA, Slakter JS, Gross NE, Spaide RF, Costa DL, Huang SJ, Klancnik JM Jr, Aizman A: Indocyanine green angiography-guided photodynamic therapy for treatment of chronic central serous chorioretinopathy: a pilot study. Retina 2003;23:288–298.
  38. Cardillo Piccolino F, Eandi CM, Ventre L, Rigault de la Longrais RC, Grignolo FM: Photodynamic therapy for chronic central serous chorioretinopathy. Retina 2003;23:752–763.
  39. Chan WM, Lam DS, Lai TY, Tam BS, Liu DT, Chan CK: Choroidal vascular remodelling in central serous chorioretinopathy after indocyanine green guided photodynamic therapy with verteporfin: a novel treatment at the primary disease level. Br J Ophthalmol 2003;87:1453–1458.
  40. Canakis C, Livir-Rallatos C, Panayiotis Z, Livir-Rallatos G, Persidis E, Conway MD, Peyman GA: Ocular photodynamic therapy for serous macular detachment in the diffuse retinal pigment epitheliopathy variant of idiopathic central serous chorioretinopathy. Am J Ophthalmol 2003;136:750–752.
  41. Taban M, Boyer DS, Thomas EL, Taban M: Chronic central serous chorioretinopathy: photodynamic therapy. Am J Ophthalmol 2004;137:1073–1080.
  42. Ober MD, Yannuzzi LA, Do DV, Spaide RF, Bressler NM, Jampol LM, Angelilli A, Eandi CM, Lyon AT: Photodynamic therapy for focal retinal pigment epithelial leaks secondary to central serous chorioretinopathy. Ophthalmology 2005;112:2088–2094.
  43. De Lahitte GD, Cohen SY, Gaudric A: Lack of apparent short-term benefit of photodynamic therapy in bilateral, acquired, parafoveal telangiectasia without subretinal neovascularization. Am J Ophthalmol 2004;138:892–894.
  44. Schmidt-Erfurth U, Hasan T, Schomacker K, Flotte T, Birngruber R: In vivo uptake of liposomal benzoporphyrin derivative and photothrombosis in experimental corneal neovascularization. Lasers Surg Med 1995;17:178–188.
  45. Holzer MP, Solomon KD, Vroman DT, Sandoval HP, Margaron P, Kasper TJ, Crosson CE: Photodynamic therapy with verteporfin in a rabbit model of corneal neovascularization. Invest Ophthalmol Vis Sci 2003;44:2954–2958.
  46. Fossarello M, Peiretti E, Zucca I, Serra A: Photodynamic therapy of corneal neovascularization with verteporfin. Cornea 2003;22:485–488.
  47. Parodi MB, Iacono P: Photodynamic therapy with verteporfin for anterior segment neovascularizations in neovascular glaucoma. Am J Ophthalmol 2004;138:157–158.
  48. Muller VA, Ruokonen P, Schellenbeck M, Hartmann C, Tetz M: Treatment of rubeosis iridis with photodynamic therapy with verteporfin – a new therapeutic and prophylactic option for patients with the risk of neovascular glaucoma? Ophthalmic Res 2003;35:60–64.
  49. Mimouni KF, Bressler SB, Bressler NM: Photodynamic therapy with verteporfin for subfoveal choroidal neovascularization in children. Am J Ophthalmol 2003;135:900–902.
  50. Harissi-Dagher M, Sebag M, Gauthier D, Marcil G, Labelle P, Arbour JD: Photodynamic therapy in young patients with choroidal neovascularization following traumatic choroidal rupture. Am J Ophthalmol 2005;139:726–728.
  51. Giansanti F, Virgili G, Varano M, Tedeschi M, Rapizzi E, Giacomelli G, Menchini U: Photodynamic therapy for choroidal neovascularization in pediatric patients. Retina 2005;25:590–596.
  52. Potter MJ, Szabo SM, Ho T: Combined photodynamic therapy and intravitreal triamcinolone for the treatment of myopic choroidal neovascularization in a 13-year-old girl. Graefes Arch Clin Exp Ophthalmol 2006;244:639–641.
  53. Postelmans L, Pasteels B, Coquelet P, El Ouardighi H, Verougstraete C, Schmidt-Erfurth U: Severe pigment epithelial alterations in the treatment area following photodynamic therapy for classic choroidal neovascularization in young females. Am J Ophthalmol 2004;138:803–808.
  54. Wachtlin J, Behme T, Heimann H, Kellner U, Foerster MH: Concentric retinal pigment epithelium atrophy after a single photodynamic therapy. Graefes Arch Clin Exp Ophthalmol 2003;241:518–521.
  55. Stur M: The potential and the limits of photodynamic therapy – a review. Klin Monatsbl Augenheilkd 2003;220:654–668.
  56. Hopley C, Salkeld G, Mitchell P: Cost utility of photodynamic therapy for predominantly classic neovascular age related macular degeneration. Br J Ophthalmol 2004;88:982–987.
  57. Jonas JB, Spandau UH, Kamppeter BA, Harder B: Follow-up after intravitreal triamcinolone acetonide for exudative age-related macular degeneration. Eye 2007;21:387–394.
  58. Chan WM, Lai TY, Wong AL, Tong JP, Liu DT, Lam DS: Combined photodynamic therapy and intravitreal triamcinolone injection for the treatment of subfoveal choroidal neovascularisation in age related macular degeneration: a comparative study. Br J Ophthalmol 2006;90:337–341.
  59. Nicolo M, Ghiglione D, Lai S, Nasciuti F, Cicinelli S, Calabria G: Occult with no classic choroidal neovascularization secondary to age-related macular degeneration treated by intravitreal triamcinolone and photodynamic therapy with verteporfin. Retina 2006;26:58–64.
  60. Spaide RF, Sorenson J, Maranan L: Photodynamic therapy with verteporfin combined with intravitreal injection of triamcinolone acetonide for choroidal neovascularization. Ophthalmology 2005;112:301–304.
  61. Augustin AJ, Schmidt-Erfurth U: Verteporfin therapy combined with intravitreal triamcinolone in all types of choroidal neovascularization due to age-related macular degeneration. Ophthalmology 2006;113:14–22.
  62. Slakter JS, Bochow TW, D’Amico DJ, Marks B, Jerdan J, Sullivan EK, Robertson SM, Slakter JS, Sullins G, Zilliox P; Anecortave Acetate Clinical Study Group: Anecortave acetate (15 milligrams) versus photodynamic therapy for treatment of subfoveal neovascularization in age-related macular degeneration. Ophthalmology 2006;113:3–13.
  63. Gragoudas ES, Adamis AP, Cunningham ET Jr, Feinsod M, Guyer DR; VEGF Inhibition Study in Ocular Neovascularization Clinical Trial Group: Pegaptanib for neovascular age-related macular degeneration. N Engl J Med 2004;351:2805–2816.
  64. Heier JS, Boyer DS, Ciulla TA, Ferrone PJ, Jumper JM, Gentile RC, Kotlovker D, Chung CY, Kim RY: Ranibizumab combined with verteporfin photodynamic therapy in neovascular age-related macular degeneration: year 1 results of the FOCUS Study. Arch Ophthalmol 2006;124:1532–1542.
  65. Avery RL, Pieramici DJ, Rabena MD, Castellarin AA, Nasir MA, Giust MJ: Intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration. Ophthalmology 2006;113:363–372.
  66. Ladewig MS, Ziemssen F, Jaissle G, Helb HM, Scholl HP, Eter N, Bartz-Schmidt KU, Holz FG: Intravitreal bevacizumab for neovascular age-related macular degeneration. Ophthalmologe 2006;103:463–470.
  67. Brown DM, Kaiser PK, Michels M, Soubrane G, Heier JS, Kim RY, Sy JP, Schneider S; ANCHOR Study Group: Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med 2006;355:1432–1444.
  68. Mennel S, Hausmann N, Meyer CH, Horle S, Peter S: Transient visual decrease after photodynamic therapy. Ophthalmologe 2005;102:58–63.
  69. Mennel S, Meyer CH: Transient visual disturbance after photodynamic therapy. Am J Ophthalmol 2005;139:748–749.
  70. Costa RA, Farah ME, Cardillo JA, Calucci D, Williams GA: Immediate indocyanine green angiography and optical coherence tomography evaluation after photodynamic therapy for subfoveal choroidal neovascularization. Retina 2003;23:159–165.
  71. Mennel S, Peter S, Meyer CH, Thumann G: Effect of photodynamic therapy on the function of the outer blood-retinal barrier in an in vitro model. Graefes Arch Clin Exp Ophthalmol 2006;244:1015–1021.
  72. Schmidt-Erfurth U, Schlotzer-Schrehard U, Cursiefen C, Michels S, Beckendorf A, Naumann GO: Influence of photodynamic therapy on expression of vascular endothelial growth factor (VEGF), VEGF receptor 3, and pigment epithelium-derived factor. Invest Ophthalmol Vis Sci 2003;44:4473–4480.
  73. Framme C, Flucke B, Birngruber R: Comparison of reduced and standard light application in photodynamic therapy of the eye in two rabbit models. Graefes Arch Clin Exp Ophthalmol 2006;244:773–781.
  74. Mennel S, Meyer CH, Zaki NV, Schmidt JC: Photodynamic therapy – why and when to add antiproliferative adjuvants. Spektrum Augenheilkd 2006;20:58.
  75. Michels S, Wachtlin J, Gamulescu MA, Heimann H, Prunte C, Inhoffen W, Krebs I, Schmidt-Erfurth U: Comparison of early retreatment with the standard regimen in verteporfin therapy of neovascular age-related macular degeneration. Ophthalmology 2005;112:2070–2075.
  76. Rodriguez-Coleman H, Yuan P, Kim H, Gravlin L, Srivastava S, Csaky KG, Robinson MR: Intravitreal injection of triamcinolone for diffuse macular edema. Arch Ophthalmol 2004;122:1085–1086.

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