This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (11)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Choroidal Neovascularization  • Ocular Imaging  • Ophthalmological Procedures, Other  • Articles for Residents  • Alert me on articles by topic

Fluorescein Angiographic Guidelines for Evaluation and Treatment—TAP and VIP Report No. 2

Treatment of Age-Related Macular Degeneration With Photodynamic Therapy (TAP) and Verteporfin in Photodynamic Therapy (VIP) Study Groups*

Arch Ophthalmol. 2003;121:1253-1268.

Objective  To describe fluorescein angiographic guidelines for the use of verteporfin therapy in patients with subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) or other conditions based on 2-year vision outcomes from the Treatment of Age-Related Macular Degeneration With Photodynamic Therapy (TAP) Investigation and Verteporfin in Photodynamic Therapy (VIP) Trial.

Methods  Three multicenter, double-masked, placebo-controlled randomized clinical trials at 28 ophthalmology clinical centers in Europe and North America involving prospectively identified patients with best-corrected visual acuity (Snellen equivalent) of approximately 20/20 to 20/200, subfoveal CNV secondary to AMD or pathologic myopia with evidence of CNV, and a lesion greatest linear dimension of 5400 µm or less. Fluorescein angiography was to be performed on all patients at enrollment and at regular 3-month follow-up visits through 2 years. The initial treatment laser spot size and all subsequent treatment decisions were based on the investigator's interpretation of these fluorescein angiograms. Photographic materials forwarded to the Wilmer Photograph Reading Center were reviewed by masked graders.

Main Outcome Measures  Baseline angiographic features, including lesion composition and size, morphologic response to treatment during follow-up (eg, absence of leakage), and reliability ( values) of grading selected characteristics based on a 10% regrading of baseline visits.

Results  Terms and examples of different lesions and lesion components are provided to assist recognition of fluorescein angiographic characteristics of choroidal neovascular lesions that were important in determining when and where to apply verteporfin therapy. The statistics for agreement of identification of lesion characteristics by the Wilmer Photograph Reading Center for these trials ranged from 0.70 to 0.85.

Conclusions  Ophthalmologists should consider interpreting fluorescein angiographic images of subfoveal lesions with terms provided to follow recommendations regarding which patients are most likely to benefit from verteporfin therapy based on results from the TAP Investigation and VIP Trial.

*Writing Committee members for the TAP and VIP Report No. 2 are listed at the end of this article. The authors' affiliations and self-reported potential conflicts of interest are given at the end of this article.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Comparison of the optical coherence tomographic features of choroidal neovascular membranes in pathological myopia versus age-related macular degeneration, using quantitative subanalysis
Keane et al.
Br. J. Ophthalmol. 2008;92:1081-1085.
ABSTRACT | FULL TEXT  

Quantitative Subanalysis of Optical Coherence Tomography after Treatment with Ranibizumab for Neovascular Age-Related Macular Degeneration
Keane et al.
IOVS 2008;49:3115-3120.
ABSTRACT | FULL TEXT  

Expression of hypoxia-inducible factor 1{alpha} and 2{alpha} in choroidal neovascular membranes associated with age-related macular degeneration
Inoue et al.
Br. J. Ophthalmol. 2007;91:1720-1721.
FULL TEXT  

Suppression of Choroidal Neovascularization by Dendritic Cell Vaccination Targeting VEGFR2
Mochimaru et al.
IOVS 2007;48:4795-4801.
ABSTRACT | FULL TEXT  

Non-responders to bevacizumab (Avastin) therapy of choroidal neovascular lesions
Lux et al.
Br. J. Ophthalmol. 2007;91:1318-1322.
ABSTRACT | FULL TEXT  

Two-year results of surgical removal of choroidal neovascular membranes related to non-age-related macular degeneration
Essex et al.
Br. J. Ophthalmol. 2007;91:649-654.
ABSTRACT | FULL TEXT  

Public Health Impact of Neovascular Age-Related Macular Degeneration Treatments Extrapolated from Visual Acuity
Bandello et al.
IOVS 2007;48:96-103.
ABSTRACT | FULL TEXT  

Ranibizumab Combined With Verteporfin Photodynamic Therapy in Neovascular Age-Related Macular Degeneration: Year 1 Results of the FOCUS Study.
Heier et al.
Arch Ophthalmol 2006;124:1532-1542.
ABSTRACT | FULL TEXT  

Ranibizumab for Neovascular Age-Related Macular Degeneration
Rosenfeld et al.
NEJM 2006;355:1419-1431.
ABSTRACT | FULL TEXT  

Some ethical considerations for the "off-label" use of drugs such as Avastin.
Wong and Kyle
Br. J. Ophthalmol. 2006;90:1218-1219.
FULL TEXT  

Lesion morphology in age-related macular degeneration and its therapeutic significance.
Beaumont and Kang
Arch Ophthalmol 2006;124:807-812.
ABSTRACT | FULL TEXT  

Occult With No Classic Subfoveal Choroidal Neovascular Lesions in Age-Related Macular Degeneration: Clinically Relevant Natural History Information in Larger Lesions With Good Vision From the Verteporfin in Photodynamic Therapy (VIP) Trial: VIP Report No. 4.
Writing Committee for the VIP Study Group
Arch Ophthalmol 2006;124:660-664.
ABSTRACT | FULL TEXT  

Optical coherence tomography to monitor photodynamic therapy in pathological myopia
Garcia-Layana et al.
Br. J. Ophthalmol. 2006;90:555-558.
ABSTRACT | FULL TEXT  

Ultrahigh resolution optical coherence tomography in non-exudative age related macular degeneration
Pieroni et al.
Br. J. Ophthalmol. 2006;90:191-197.
ABSTRACT | FULL TEXT  

Retinal Anastomosis to Choroidal Neovascularization: A Bum Rap for a Difficult Disease
Bressler
Arch Ophthalmol 2005;123:1741-1743.
FULL TEXT  

Complications After Photodynamic Therapy
Schnurrbusch et al.
Arch Ophthalmol 2005;123:1347-1350.
ABSTRACT | FULL TEXT  

Macular Function after PDT in Myopic Maculopathy: Psychophysical and Electrophysiological Evaluation
Varano et al.
IOVS 2005;46:1453-1462.
ABSTRACT | FULL TEXT  

Verteporfin Therapy of Subfoveal Minimally Classic Choroidal Neovascularization in Age-Related Macular Degeneration: 2-Year Results of a Randomized Clinical Trial
Visudyne in Minimally Classic Choroidal Neovascula
Arch Ophthalmol 2005;123:448-457.
ABSTRACT | FULL TEXT  

Impact of lesion size on photodynamic therapy with verteporfin of predominantly classic lesions in age related macular degeneration
Arias et al.
Br. J. Ophthalmol. 2005;89:312-315.
ABSTRACT | FULL TEXT  

Photodynamic Therapy With Verteporfin: Observations on the Introduction of a New Treatment Into Clinical Practice
Schein et al.
Arch Ophthalmol 2005;123:58-63.
ABSTRACT | FULL TEXT  

Surgical Removal vs Observation for Subfoveal Choroidal Neovascularization, Either Associated With the Ocular Histoplasmosis Syndrome or Idiopathic: I. Ophthalmic Findings From a Randomized Clinical Trial: Submacular Surgery Trials (SST) Group H Trial: SST Report No. 9
Submacular Surgery Trials Research Group
Arch Ophthalmol 2004;122:1597-1611.
ABSTRACT | FULL TEXT  

Natural History of Minimally Classic Subfoveal Choroidal Neovascular Lesions in the Treatment of Age-Related Macular Degeneration With Photodynamic Therapy (TAP) Investigation: Outcomes Potentially Relevant to Management--TAP Report No. 6
Bressler et al.
Arch Ophthalmol 2004;122:325-329.
ABSTRACT | FULL TEXT