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Tounakaki O, Tsakou Α, Malamas A, Chrisoula D, Ioannis S, Elias Z. Assessment of reporting quality of meta-analyses of randomized controlled trials in neovascular age-related macular degeneration published from April 2014 to May 2018 using prisma statement. Int Ophthalmol 2020; 40:1163-1180. [DOI: 10.1007/s10792-019-01282-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 12/31/2019] [Indexed: 01/10/2023]
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Kessel D. Photodynamic Therapy: A Brief History. J Clin Med 2019; 8:E1581. [PMID: 31581613 PMCID: PMC6832404 DOI: 10.3390/jcm8101581] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 09/25/2019] [Accepted: 09/25/2019] [Indexed: 12/23/2022] Open
Abstract
Photodynamic therapy (PDT) involves the selective sensitization of tissues to light. A major advance in the field occurred when Thomas Dougherty at the Roswell Park Cancer Institute initiated a series of clinical studies that eventually led to FDA approval of the procedure. This report contains a summary of Dougherty's contributions and an assessment of where this has led, along with a summary of implications for future drug development.
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Affiliation(s)
- David Kessel
- Department of Pharmacology, Wayne State University School of Medicine, Detroit, MI 48201, USA.
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Parmeggiani F, Gallenga CE, Costagliola C, Semeraro F, Romano MR, Dell'Omo R, Russo A, De Nadai K, Gemmati D, D'Angelo S, Bolletta E, Sorrentino FS. Impact of methylenetetrahydrofolate reductase C677T polymorphism on the efficacy of photodynamic therapy in patients with neovascular age-related macular degeneration. Sci Rep 2019; 9:2614. [PMID: 30796269 PMCID: PMC6385217 DOI: 10.1038/s41598-019-38919-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 01/02/2019] [Indexed: 02/07/2023] Open
Abstract
The most severe visual impairments due to age-related macular degeneration (AMD) are frequently caused by the occurrence of choroidal neovascularization (CNV). Although photodynamic therapy with verteporfin (PDT-V) is currently a second-line treatment for neovascular AMD, it can be conveniently combined with drugs acting against vascular endothelial growth factor (anti-VEGF) to reduce the healthcare burden associated with the growing necessity of anti-VEGF intravitreal re-injection. Because the common 677 C > T polymorphism of the methylenetetrahydrofolate reductase gene (MTHFR-C677T; rs1801133) has been described as predictor of satisfactory short-term responsiveness of AMD-related CNV to PDT-V, we retrospectively examined the outcomes of 371 Caucasian patients treated with standardized, pro-re-nata, photodynamic regimen for 24 months. Responder (R) and non-responder (NR) patients were distinguished on the basis of the total number of scheduled PDT-V (TN-PDT-V) and change of best-corrected visual acuity (∆-BCVA). The risk for both TN-PDT-V and ∆-BCVA to pass from R to NR group was strongly correlated with CT and TT genotypes of MTHFR-C677T variant resulting, respectively, in odd ratios of 0.19 [95% CI, 0.12-0.32] and 0.09 [95% CI, 0.04-0.21] (P < 0.001), and odd ratios of 0.24 [95% CI, 0.15-0.39] and 0.03 [95% CI, 0.01-0.11] (P < 0.001). These pharmacogenetic findings indicate a rational basis to optimize the future clinical application of PDT-V during the combined treatments of AMD-related CNV, highlighting the role of thrombophilia to be aware of the efficacy profile of photodynamic therapy.
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Affiliation(s)
- Francesco Parmeggiani
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, 44121, Italy. .,Center for the Study of Inflammation of the University of Ferrara, Ferrara, 44121, Italy.
| | - Carla Enrica Gallenga
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, 44121, Italy
| | - Ciro Costagliola
- Department of Medicine and Health Sciences, University of Molise, Campobasso, 86100, Italy
| | - Francesco Semeraro
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, 25121, Italy
| | - Mario R Romano
- Department of Biomedical Sciences, Humanitas University, Milan, 20090, Italy
| | - Roberto Dell'Omo
- Department of Medicine and Health Sciences, University of Molise, Campobasso, 86100, Italy
| | - Andrea Russo
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, 25121, Italy
| | - Katia De Nadai
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, 44121, Italy.,Center for Retinitis Pigmentosa of Veneto Region, Camposampiero Hospital, Azienda ULSS 6 Euganea, Padova, 35131, Italy
| | - Donato Gemmati
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, 44121, Italy
| | - Sergio D'Angelo
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, 44121, Italy
| | - Elena Bolletta
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, 44121, Italy
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Tong Y, Zhao KK, Feng D, Biswal M, Zhao PQ, Wang ZY, Zhang Y. Comparison of the efficacy of anti-VEGF monotherapy versus PDT and intravitreal anti-VEGF combination treatment in AMD: a Meta-analysis and systematic review. Int J Ophthalmol 2016; 9:1028-37. [PMID: 27500113 DOI: 10.18240/ijo.2016.07.16] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 04/01/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To compare the effect of anti-vascular endothelial growth factor (VEGF) monotherapy versus photodynamic therapy (PDT) and anti-VEGF combination treatment in age-related macular degeneration (AMD). METHODS A computerized online search was performed using PubMed, Web of Science and the Cochrane Library. Studies that compared anti-VEGF monotherapy with PDT and anti-VEGF combination treatment of AMD and were designed as randomized controlled trials were included. The means and standard deviations of the best-corrected visual acuity (BCVA), central retinal thickness (CRT), number of treatments and proportions of patients who gained BCVA ≥15, 10, 5, or 0 letters at 12(th) month were extracted. A systematic review and Meta-analysis of the comparison of the two approaches was conducted using Review Manager 5.2. Subgroup. A sensitivity analysis was also performed. RESULTS Eight studies were included. When the subgroup and sensitivity analysis was conducted, the results indicated that in the findings that included the monotherapy group and PDT (standard fluence, SF) group of Kaiser's study, the patients in the monotherapy group had a better BCVA compared with the combination group at 12(th) month in the PDT (SF) subgroup [weighted mean difference (WMD): 3.54; 95%CI: 0.36 to 6.73; P=0.03], and there were more patients who gained ≥15 letters of BCVA in the monotherapy group compared with the combination group in the total result [odds ratio (OR): 1.41; 95%CI: 1.02 to 1.95; P=0.04]. The same conclusion was obtained in the total result that included the monotherapy group and PDT (reduced fluence, RF) group of Kaiser's study (OR: 1.56; 95%CI: 1.13 to 2.15; P=0.007). However, there were no significant differences in the other indexes between the two therapies. CONCLUSION We found that anti-VEGF monotherapy is more effective on the recovery of visual acuity than combination therapy and more researches with lager sample size should be performed to study on the effect of the two therapy approaches on CRT and number of injections.
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Affiliation(s)
- Yao Tong
- Eye Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China; Department of Ophthalmology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
| | - Ke-Ke Zhao
- Department of Ophthalmology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
| | - Dong Feng
- Department of Ophthalmology, The First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou 310006, Zhejiang Province, China
| | - Manas Biswal
- Department of Molecular Genetics, University of Florida, Gainesville 32610, Florida, USA
| | - Pei-Quan Zhao
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
| | - Zhao-Yang Wang
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
| | - Yun Zhang
- Eye Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
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Tang K, Si JK, Guo DD, Cui Y, Du YX, Pan XM, Bi HS. Ranibizumab alone or in combination with photodynamic therapy vs photodynamic therapy for polypoidal choroidal vasculopathy: a systematic review and Meta-analysis. Int J Ophthalmol 2015; 8:1056-66. [PMID: 26558226 DOI: 10.3980/j.issn.2222-3959.2015.05.36] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 01/30/2015] [Indexed: 01/10/2023] Open
Abstract
AIM To compare the efficacy of intravitreal ranibizumab (IVR) alone or in combination with photodynamic therapy (PDT) vs PDT in patients with symptomatic polypoidal choroidal vasculopathy (PCV). METHODS A systematic search of a wide range of databases (including PubMed, EMBASE, Cochrane Library and Web of Science) was searched to identify relevant studies. Both randomized controlled trials (RCTs) and non-RCT studies were included. Methodological quality of included literatures was evaluated according to the Newcastle-Ottawa Scale. RevMan 5.2.7 software was used to do the Meta-analysis. RESULTS Three RCTs and 6 retrospective studies were included. The results showed that PDT monotherapy had a significantly higher proportion in patients who achieved complete regression of polyps than IVR monotherapy at months 3, 6, and 12 (All P≤0.01), respectively. However, IVR had a tendency to be more effective in improving vision on the basis of RCTs. The proportion of patients who gained complete regression of polyps revealed that there was no significant difference between the combination treatment and PDT monotherapy. The mean change of best-corrected visual acuity (BCVA) from baseline showed that the combination treatment had significant superiority in improving vision vs PDT monotherapy at months 3, 6 and 24 (All P<0.05), respectively. In the mean time, this comparison result was also significant at month 12 (P<0.01) after removal of a heterogeneous study. CONCLUSION IVR has non-inferiority compare with PDT either in stabilizing or in improving vision, although it can hardly promote the regression of polyps. The combination treatment of PDT and IVR can exert a synergistic effect on regressing polyps and on maintaining or improving visual acuity. Thus, it can be the first-line therapy for PCV.
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Affiliation(s)
- Kai Tang
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250002, Shandong Province, China ; Department of Ophthalmology, Shandong University of Traditional Chinese Medicine, Jinan 250002, Shandong Province, China
| | - Jun-Kang Si
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250002, Shandong Province, China ; Department of Ophthalmology, Shandong University of Traditional Chinese Medicine, Jinan 250002, Shandong Province, China
| | - Da-Dong Guo
- Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan 250002, Shandong Province, China
| | - Yan Cui
- Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan 250002, Shandong Province, China
| | - Yu-Xiang Du
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250002, Shandong Province, China ; Department of Ophthalmology, Shandong University of Traditional Chinese Medicine, Jinan 250002, Shandong Province, China
| | - Xue-Mei Pan
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250002, Shandong Province, China
| | - Hong-Sheng Bi
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250002, Shandong Province, China ; Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan 250002, Shandong Province, China
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Kessel D. More Adventures in Photodynamic Therapy. Int J Mol Sci 2015; 16:15188-93. [PMID: 26151850 PMCID: PMC4519894 DOI: 10.3390/ijms160715188] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 06/23/2015] [Accepted: 06/23/2015] [Indexed: 11/21/2022] Open
Abstract
Photodynamic therapy is a procedure that can provide a selective eradication of neoplastic disease if sufficient drug, light, and oxygen are available. As this description suggests, it involves the photosensitization of malignant tissues to irradiation with photons in the visible range. While not suitable for tumors at unknown loci, it can be of use for eradication of cancer at surgical margins and therapy at sites where substantial surgery might otherwise be involved. Drug development has been delayed by several factors including the reluctance of major pharmaceutical firms in the United States to invest in this technology along with some unwise approaches in the past.
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Affiliation(s)
- David Kessel
- Department of Pharmacology, Wayne State University School of Medicine, 540 E Canfield Street, Detroit, MI 48201, USA.
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