Mechanisms of action of photodynamic therapy with verteporfin for the treatment of age-related macular degeneration

Surv Ophthalmol. 2000 Nov-Dec;45(3):195-214. doi: 10.1016/s0039-6257(00)00158-2.


Age-related macular degeneration, especially the neovascular form of the disease, is the leading cause of blindness in elderly people in developed countries. Thermal photocoagulation is still the preferred treatment for choroidal neovascularization that does not involve the fovea, but it is suitable for only a small number of patients and it can lead to immediate loss of visual acuity. Photodynamic therapy with use of photochemical light activation of verteporfin as a photosensitizer (verteporfin therapy) has been shown to be effective in treating vascularized tumors, and its potential to treat other conditions involving neovascularization has also been suggested. Preclinical and clinical studies have indicated that verteporfin therapy can be used to treat choroidal neovascularization secondary to age-related macular degeneration effectively and safely. Selective occlusion of choroidal neovasculature by this therapy causes minimal damage to the neurosensory retina and, therefore, does not induce loss of visual acuity. This benefit allows verteporfin therapy to be used in the large proportion of patients who are not eligible for treatment by laser photocoagulation. The mechanistic aspects of the mode of action of light-activated verteporfin are described in this review.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Animals
  • Fluorescein Angiography
  • Fundus Oculi
  • Humans
  • Macula Lutea / drug effects
  • Macula Lutea / pathology
  • Macular Degeneration / diagnosis
  • Macular Degeneration / drug therapy*
  • Photochemotherapy*
  • Photosensitizing Agents / administration & dosage
  • Photosensitizing Agents / therapeutic use*
  • Porphyrins / administration & dosage
  • Porphyrins / therapeutic use*
  • Prognosis
  • Verteporfin
  • Visual Acuity


  • Photosensitizing Agents
  • Porphyrins
  • Verteporfin