Subfoveal choroidal neovascularisation (CNV)

Verteporfin photodynamic therapy (PDT) is a two-step process:

The first step is a 10-minute intravenous infusion of verteporfin at a dose of 6 mg/m² body surface area, diluted in 30 ml infusion solution.

The second step is the light activation of verteporfin at 15 minutes after the start of the infusion.

Patients should be re-evaluated every 3 months. In the event of recurrent CNV leakage, verteporfin therapy may be given up to 4 times per year.

Treatment of the second eye with verteporfin

There are no clinical data to support concomitant treatment of the second eye. However, if treatment of the second eye is deemed necessary, light should be applied to the second eye immediately after light application in the first eye but no later than 20 minutes from the start of the infusion.

For the light activation of verteporfin, a diode laser generating non-thermal red light (wavelength 689 nm ± 3 nm) is used via a slit lamp mounted fibre optic device and a suitable contact lens. At the recommended light intensity of 600 mW/cm², it takes 83 seconds to deliver the required light dose of 50 J/cm².

The greatest linear dimension of the choroidal neovascular lesion is estimated using fluorescein angiography and fundus photography. Fundus cameras with a magnification within the range of 2.4-2.6X are recommended. The treatment spot should cover all neovasculature, blood and/or blocked fluorescence. To ensure treatment of poorly demarcated lesion borders, an additional margin of 500 μm should be added around the visible lesion. The nasal edge of the treatment spot must be at least 200 μm from the temporal edge of the optic disc. The maximum spot size used for the first treatment in the clinical studies was 6,400 μm. For treatment of lesions that are larger than the maximum treatment spot size, apply the light to the greatest possible area of active lesion.

It is important to follow the above recommendations to achieve the optimal treatment effect.