Biophotonics and Photodynamic Therapy: Emerging Optics-Based Treatments for Eye Conditions

Osamah Ali Saleh Alsanosi (1), Rayan Abdullah Hamed Albeladi (2), Khaled Abdullah Hamed Albeladi (3), Fayez Mohammed Ahmed Al-Zahrani (4), Ahmed Mohammed D Alqarni (5), Ahmad Mohammed Alahmary (6), Omar Mohammed Asiri (7), Ahmad Abdulrhman Maqbol Alharthi (8), Sultan Abdulrahman Al Qahtani , Sarah Mohammed Abdullah Alotaibi , Turki yahya safhi (9)
(1) King Salman Bin Abdulaziz Medical City,Ministry of Health, Saudi Arabia,
(2) King Salman Medical City, Ministry of Health, Saudi Arabia,
(3) King Salman Bin Abdulaziz Medical City - Madinah General Hospital,Ministry of Health, Saudi Arabia,
(4) Security Forces Hospital Program – Riyadh, Ministry of Health, Saudi Arabia,
(5) Al-Muzahmiya Hospital, Riyadh, Ministry of Health, Saudi Arabia,
(6) King Salman Hospital, Riyadh, Ministry of Health, Saudi Arabia,
(7) Al-Muzahmiya General Hospital, Riyadh, Ministry of Health, Saudi Arabia,
(8) Al-Tagamoa Al-Thani, Jeddah Eye Hospital, Ministry of Health, Saudi Arabia,
(9) Jazan, Ministry of Health, Saudi Arabia

Abstract

Background: Ophthalmic medicine is increasingly leveraging the precision of light-based technologies for diagnosis and treatment. Biophotonics, the interaction of light with biological systems, and Photodynamic Therapy (PDT), a light-activated treatment, represent paradigm shifts in managing complex eye diseases. These provide targeted approaches with fewer adverse effects compared to conventional treatments.


Aim: The aim is to synthesize current evidence and technological advances in the years between 2013 and 2025 about the use of biophotonics and PDT to treat a range of ocular pathologies, from AMD to corneal disorders and oncological pathologies.


Methods: A narrative literature review was performed using PubMed, Scopus, and Web of Science. Search terms included "ophthalmic biophotonics," "photodynamic therapy," "verteporfin," "corneal cross-linking," "retinal imaging," and "light-guided therapy." 


Results: The evidence confirms the established role of PDT in treating neovascular AMD and central serous chorioretinopathy. Significant refinements are noted toward the optimization of PDT parameters ("half-dose," "half-fluence") to enhance safety. Novel applications of PDT are emerging, such as in corneal neovascularization and ocular tumors. Simultaneously, biophotonic techniques, including two-photon microscopy and optogenetics, are entering the clinical arena from the research domain, providing unprecedented diagnostics at the cellular level and vision restoration strategies.


Conclusion: Biophotonics and PDT represent the cornerstone technologies in current ophthalmology. Their evolution to more selective, personalized, and combination treatments promises an improvement in therapeutic outcomes and further extension of the frontiers of eye diseases that can be treated. Future integration with AI and nanotechnology will continue to cement their leading role in the revolution of ophthalmic care.

Full text article

Generated from XML file

References

Age-Related Eye Disease Study 2 (AREDS2) Research Group. (2013). Lutein+ zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial. Jama, 309(19), 2005-2015. doi:10.1001/jama.2013.4997

Ahn, S. J. (2025). Retinal Thickness Analysis Using Optical Coherence Tomography: Diagnostic and Monitoring Applications in Retinal Diseases. Diagnostics, 15(7), 833. https://doi.org/10.3390/diagnostics15070833

Altamirano, D., Martinez, J., Leviste, K. D., Parel, J. M., & Amescua, G. (2020). Photodynamic therapy for infectious keratitis. Current ophthalmology reports, 8(4), 245-251. https://doi.org/10.1007/s40135-020-00252-y

Altınel, M. G., Acikalin, B., Gunes, H., & Demir, G. (2021). Optical coherence tomography parameters as predictors of treatment response to a 577-nm subthreshold micropulse laser in chronic central serous chorioretinopathy. Lasers in Medical Science, 36(7), 1505-1514. https://doi.org/10.1007/s10103-020-03225-6

Al-Torbak, A. A. (2012). Photodynamic therapy with verteporfin for corneal neovascularization. Middle East African journal of ophthalmology, 19(2), 185-189. DOI: 10.4103/0974-9233.95246

Bousquet, E., Bonnin, S., Mrejen, S., Krivosic, V., Tadayoni, R., & Gaudric, A. (2018). Optical coherence tomography angiography of flat irregular pigment epithelium detachment in chronic central serous chorioretinopathy. Retina, 38(3), 629-638. DOI: 10.1097/IAE.0000000000001580

Busskamp, V., Roska, B., & Sahel, J. A. (2024). Optogenetic vision restoration. Cold Spring Harbor Perspectives in Medicine, 14(8), a041660. doi: 10.1101/cshperspect.a041660

Cabrera, F. J., Wang, D. C., Reddy, K., Acharya, G., & Shin, C. S. (2019). Challenges and opportunities for drug delivery to the posterior of the eye. Drug discovery today, 24(8), 1679-1684. https://doi.org/10.1016/j.drudis.2019.05.035

Carroll, J., Kay, D. B., Scoles, D., Dubra, A., & Lombardo, M. (2013). Adaptive optics retinal imaging–clinical opportunities and challenges. Current eye research, 38(7), 709-721. https://doi.org/10.3109/02713683.2013.784792

Ferrara, N., & Adamis, A. P. (2016). Ten years of anti-vascular endothelial growth factor therapy. Nature reviews Drug discovery, 15(6), 385-403. https://doi.org/10.1038/nrd.2015.17

Hong, M., Chong, S. Z., Goh, Y. Y., & Tong, L. (2024). Two-photon and multiphoton microscopy in anterior segment diseases of the eye. International Journal of Molecular Sciences, 25(3), 1670. https://doi.org/10.3390/ijms25031670

Hovakimyan, M., Guthoff, R. F., & Stachs, O. (2012). Collagen cross‐linking: current status and future directions. Journal of Ophthalmology, 2012(1), 406850. https://doi.org/10.1155/2012/406850

Iacono, P., Tedeschi, M., Boccassini, B., Chiaravalloti, A., Varano, M., & Parravano, M. (2019). Chronic central serous chorioretinopathy: early and late morphological and functional changes after verteporfin photodynamic therapy. Retina, 39(5), 980-987. DOI: 10.1097/IAE.0000000000002040

Iacono, P., Da Pozzo, S., Varano, M., & Parravano, M. (2020). Photodynamic therapy with verteporfin for chronic central serous chorioretinopathy: a review of data and efficacy. Pharmaceuticals, 13(11), 349. https://doi.org/10.3390/ph13110349

Kumar, A., Shankar, S., Singh, A., Mishra, S., Kumar, P., & Arora, A. (2022). Photodynamic therapy in the treatment of circumscribed choroidal hemangioma: current perspectives. Photodiagnosis and Photodynamic Therapy, 39, 103000. https://doi.org/10.1016/j.pdpdt.2022.103000

Lin, T. H., Lin, H. Y., & Tseng, P. C. (2025). Enhancing anti-vascular endothelial growth factor with photodynamic therapy for polypoidal choroidal vasculopathy: A meta-analysis. Survey of Ophthalmology, 70(3), 380-388. https://doi.org/10.1016/j.survophthal.2024.12.006

Mirshahi, R., Naseripour, M., Ghomashi, A., & Falavarjani, K. G. (2024). Clinical predictive factors and imaging biomarkers of treatment response to half dose PDT in patients with chronic central serous chorioretinopathy. Photodiagnosis and Photodynamic Therapy, 48, 104224. https://doi.org/10.1016/j.pdpdt.2024.104224

Nguyen, V., Barthelmes, D., & Gillies, M. C. (2021). Neovascular age‐related macular degeneration: A review of findings from the real‐world Fight Retinal Blindness! registry. Clinical & Experimental Ophthalmology, 49(7), 652-663. https://doi.org/10.1111/ceo.13949

Rabiolo, A., & Bandello, F. (2020). Eplerenone is not superior to placebo for chronic central serous chorioretinopathy. The Lancet, 395(10220), 252-253. https://doi.org/10.1016/S0140-6736(19)33132-0

Reinhard, A., Sandborn, W. J., Melhem, H., Bolotine, L., Chamaillard, M., & Peyrin-Biroulet, L. (2015). Photodynamic therapy as a new treatment modality for inflammatory and infectious conditions. Expert review of clinical immunology, 11(5), 637-657. https://doi.org/10.1586/1744666X.2015.1032256

Sarac, O., Caglayan, M., Uysal, B. S., Uzel, A. G. T., Tanriverdi, B., & Cagil, N. (2018). Accelerated versus standard corneal collagen cross-linking in pediatric keratoconus patients: 24 months follow-up results. Contact Lens and Anterior Eye, 41(5), 442-447. https://doi.org/10.1016/j.clae.2018.06.001

Sarma, P., Kaur, H., Hafezi, F., Bhattacharyya, J., Kirubakaran, R., Prajapat, M., ... & Bhattacharyya, A. (2023). Short-and long-term safety and efficacy of corneal collagen cross-linking in progressive keratoconus: a systematic review and meta-analysis of randomized controlled trials. Taiwan Journal of Ophthalmology, 13(2), 191-202. DOI: 10.4103/2211-5056.361974

Schmidt-Erfurth, U. M., & Pruente, C. (2007). Management of neovascular age-related macular degeneration. Progress in retinal and eye research, 26(4), 437-451. https://doi.org/10.1016/j.preteyeres.2007.03.002

Shields, C. L., Dalvin, L. A., Lim, L. A. S., Chang, M., Udyaver, S., Mazloumi, M., ... & Shields, J. A. (2020). Circumscribed choroidal hemangioma: visual outcome in the pre-photodynamic therapy era versus photodynamic therapy era in 458 cases. Ophthalmology Retina, 4(1), 100-110. https://doi.org/10.1016/j.oret.2019.08.004

Spaide, R. F., Fujimoto, J. G., Waheed, N. K., Sadda, S. R., & Staurenghi, G. (2018). Optical coherence tomography angiography. Progress in retinal and eye research, 64, 1-55. https://doi.org/10.1016/j.preteyeres.2017.11.003

Turkoglu, E. B., Pointdujour-Lim, R., Mashayekhi, A., & Shields, C. L. (2019). Photodynamic therapy as primary treatment for small choroidal melanoma. Retina, 39(7), 1319-1325. DOI: 10.1097/IAE.0000000000002169

van Dijk, E. H., Feenstra, H. M., Bjerager, J., Grauslund, J., Boon, C. J., & Subhi, Y. (2023). Comparative efficacy of treatments for chronic central serous chorioretinopathy: a systematic review with network meta‐analyses. Acta Ophthalmologica, 101(2), 140-159. https://doi.org/10.1111/aos.15263

Yin, X. F., Wu, M. H., Jin, C. J., & Zhou, S. Y. (2024). Comparison of photodynamic therapy with two different parameters combined with subconjunctival injection of bevacizumab for corneal neovascularization. Photodiagnosis and Photodynamic Therapy, 46, 104067. https://doi.org/10.1016/j.pdpdt.2024.104067

Yoon, H. J., Kim, M. K., Seo, K. Y., Ueta, M., & Yoon, K. C. (2019). Effectiveness of photodynamic therapy with verteporfin combined with intrastromal bevacizumab for corneal neovascularization in Stevens–Johnson syndrome. International ophthalmology, 39(1), 55-62. https://doi.org/10.1007/s10792-017-0786-x

Zhang, Y. S., Onishi, A. C., Zhou, N., Song, J., Samra, S., Weintraub, S., & Fawzi, A. A. (2019). Characterization of inner retinal hyperreflective alterations in early cognitive impairment on adaptive optics scanning laser ophthalmoscopy. Investigative ophthalmology & visual science, 60(10), 3527-3536. https://doi.org/10.1167/iovs.19-27135

Authors

Osamah Ali Saleh Alsanosi
oalsanosi@moh.gov.sa (Primary Contact)
Rayan Abdullah Hamed Albeladi
Khaled Abdullah Hamed Albeladi
Fayez Mohammed Ahmed Al-Zahrani
Ahmed Mohammed D Alqarni
Ahmad Mohammed Alahmary
Omar Mohammed Asiri
Ahmad Abdulrhman Maqbol Alharthi
Sultan Abdulrahman Al Qahtani
Sarah Mohammed Abdullah Alotaibi
Turki yahya safhi
Alsanosi, O. A. S., Rayan Abdullah Hamed Albeladi, Khaled Abdullah Hamed Albeladi, Fayez Mohammed Ahmed Al-Zahrani, Ahmed Mohammed D Alqarni, Ahmad Mohammed Alahmary, … Turki yahya safhi. (2025). Biophotonics and Photodynamic Therapy: Emerging Optics-Based Treatments for Eye Conditions. Saudi Journal of Medicine and Public Health, 2(2), 1272–1278. https://doi.org/10.64483/202522275

Article Details

Similar Articles

1 2 3 4 5 > >> 

You may also start an advanced similarity search for this article.