Photodynamic therapy with verteporfirin in corneal neovascularization
Main Article Content
Keywords
Corneal transplantation, Photochemotherapy, Corneal neovascularization
Abstract
Objective: to evaluate vascular involution of corneal neovessels followed by the application of photodynamic therapy (PDT) verteporfirina.
Methods: prospective, longitudinal, case series. Fifty eyes of 49 candidate patients to partial penetrating keratoplasty (PPK) also called corneal transplant (CT) at risk of corneal neovascularization (CN) of two or more quadrants and which were previous treated with intravenous PDT. The monitoring was carried out with photographic control of the anterior segment assessing adverse effects and development of CN.
Results: the length of the CN before and after PDT were 4.39 ± 2.24 vs. 3.71 ± 2.48 (p < 0.0001) respectively. This involution was maintained after two months of follow up. One eye (2 %) presented changes keratometry (keratometric astigmatism). Of the total 45 (90 %) of patients who showed a reduction in the CN, had revascularization within the following six months of intervention.
Conclusions: the PDT with verteporfirina is effective and safe for decreasing the length of the CN, without local and systemic adverse effects. However it is suggested to schedule the surgery two months after to permit revascularization.
References
Straiko MD, Shamie N, Terry M. Endothelial keratoplasty: past, present, and future directions. Int Ophthalmol Clin 2010;50(3):123-135.
Price MO, Thompson RW Jr, Price FW Jr. Risk factors of various causes of failure in initial corneal grafts. Arch Ophthalmol 2003;121:1087-1092.
Banerjee S, Dick AD, Nicholls SM. Transplantation 2004;77(4):492-496.
Holzer MP, Solomon KD, Vroman DT, Sandoval HP, Margaron P, Kasper TJ, et al. Phothodynamic therapy with verteporfirin in a rabbit model of corneal neovascularization. Invest Ophthalmol Vis Sci 2003;44;2954-2958.
Usui T, Ishida S, Amano S. Inflammatory corneal neovascularization and tissue renin-angiotensin system. Cornea 2009;28 (11):S54-S57.
Yoon KC, Ahn KY, Lee SE, Kim KK, Im SK, Oh HJ, et al. Experimental inhibition of corneal neovascularization by photodynamic therapy with verteporfirin. Curr Eyes Res 2006;31(3):215-224.
Hamrah P. High risk penetrant keratoplasty. Arch Soc Esp Oftalmol 2005;80(1):5-7.
Ambati BK, Marcus DM, Ratanasit A. Photodynamic therapy for corneal neovascularization and lipid degeneration. Br J Ophthalmol 2004;88(6): 840.
. Fossarello M, Peiretti E, Zucca I, Perra MT, Serra A. Photodynamic therapy of pterygium with verte-porfirin: a preliminary report. Cornea 2004;23(4): 330-338.
Yoon KC, You IC, Kang IS, Im SK, Ahn JK, Park YG, et al. Photodynamic therapy with verteporfirin for corneal neovascularization. Am J Ophthalmol 2007;144(3):390-395.
Maar N, Pemp B, Kircher K, Luksch A, Weigert G, Polska E, et al. Ocular haemodynamic chan-ges after single treatment with photodynamic the-rapy assessed with non-invasive techiques. Acta Ophthalmol 2009;87(6):631-637.
Calzavara-Pinton PG, Venturini M, Sala R. Photody-namic therapy: update 2006. Part 1: photochemistry and photobiology. J Eur Acad Dermatol Venereol 2007;21(3):293-302.
Huang Z. A review of progress in clinical photody-namic therapy. Technol Cancer Res Treat 2005; 4(3):283-293.
Fosarello M, Peiretti E, Zucca I, Serra A. Photody-namic therapy of corneal neovascularization with verteporfirin. Cornea 2003;22(5):485-488.
Ruiz-Moreno JM, Montero JA. Terapia fotodinámica en la neovascularización coroidea asociada a alta miopía. España: Instituto Oftalmológico de Alicante Universidad “Miguel Hernández”/Editorial Macline; 2003. p. 33-36, 41-44.
Sugisaki K, Usui T, Nishiyama N, Jang WD, Yanagi Y, Yamagami S, et al. Photodynamic therapy using polymeric micelles encapsulating dendrimer porphyrins. Invest Ophthalmol Vis Sci 2008;49: 894-899.
Joussen AM, Beecken WD, Moromizato Y, Schwartz A, Kirchhof B, Poulaki V. Inhibition of inflammatory corneal angiogenesis by TNP-470. Invest Ophthalmol Vis Sci 2001;42:2510-2516.