Verteporfin (Photodynamic Therapy)

How it works

After intravenous administration it accumulates in abnormal neovascular endothelium and, when activated by non-thermal red laser light, generates reactive oxygen species that cause local vascular occlusion of the targeted neovascular membrane.

Prescribing in practice

• Patients become markedly photosensitive after infusion and must avoid direct sunlight and bright indoor light to the skin and eyes until the drug has cleared, as severe phototoxic skin burns can occur.
• Administered only by clinicians trained in ophthalmic photodynamic therapy, with the timed laser activation following the infusion window precisely.
• Extravasation can cause local tissue damage and severe pain, so secure intravenous access and infusion-site monitoring are essential.

Monitoring

Monitor the infusion site for extravasation during administration and review visual acuity and macular response at scheduled follow-up.

Counselling the patient

• Avoid direct sunlight and bright light exposure to skin and eyes for the advised period; wear protective clothing and a wide-brimmed hat outdoors.
• Report any infusion-site pain, swelling or visual disturbance promptly.

Evidence & guidelines

The TAP and VIP trials established verteporfin photodynamic therapy for neovascular age-related macular degeneration, a role since largely supplanted by anti-VEGF therapy.