Miscellaneous ocular agents:
Indications for VISUDYNE:
Treatment of patients with predominantly classic subfoveal choroidal neovascularization due to age-related macular degeneration, pathologic myopia or presumed ocular histoplasmosis.
See literature regarding lesion size determination, spot size determination, light administration, and concurrent bilateral treatment. Use largest arm vein possible for inj; avoid small veins of the back of the hand. Give by IV infusion over 10 minutes at a rate of 3mL/min. Usual dose: 6mg/m2. After infusion, the second step is activation of verteporfin with light from a nonthermal diode laser. Reevaluate every 3 months and if choroidal neovascular leakage is detected on fluorescein angiography, therapy should be repeated.
Avoid sunlight or bright indoor light exposure of skin or eyes for 5 days after injection. If severe decrease of vision of ≥4 lines within 1 week after treatment, do no retreat; wait until vision recovers to pretreatment levels. Use of incompatible lasers could result in incomplete treatment. Stop infusion immediately if extravasation occurs; treat. Moderate to severe hepatic impairment. Biliary obstruction. Elderly. Pregnancy (Cat.C). Nursing mothers: not recommended.
Calcium channel blockers, polymyxin B, radiation therapy: may enhance rate of verteporfin uptake by vascular endothelium. Increased risk of photosensitivity reactions with concomitant photosensitizing agents (eg, tetracyclines, sulfonamides, phenothiazines, sulfonylureas, thiazides, griseofulvin). May be antagonized by dimethyl sulfoxide, β-carotene, ethanol, formate, mannitol, drugs that decrease clotting, vasoconstriction, or platelet aggregation (eg, thromboxane A2 inhibitors).
Inj site reactions (eg, pain, edema, inflammation, extravasation, rash, hemorrhage, discoloration), visual disturbances (eg, blurred vision, flashes of light, decreased visual acuity, visual field defects including scotoma); others.