***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: 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 r and omized clinical trials at 28 ophthalmology clinical centers in Europe and North America involving prospect ively 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 micro m 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 material s forwarded to the Wilmer Photograph Reading Center were review ed by masked grade rs . MAIN OUTCOME MEASURES Baseline angiographic features , including lesion composition and size , morphologic response to treatment during follow-up ( eg , absence of leakage ) , and reliability ( kappa 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 kappa 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 PURPOSE To evaluate vascular changes documented by confocal indocyanine green angiography ( ICGA ) through 2 years after photodynamic therapy ( PDT ) with verteporfin of neovascular age-related macular degeneration ( AMD ) . DESIGN Single-center , 2-year , r and omized , double-masked , interventional , placebo-controlled trial ( subset from Treatment of AMD with PDT Study [ TAP ] ) . PARTICIPANTS Sixty patients with subfoveal choroidal neovascularization ( CNV ) result ing from AMD . INTERVENTION Patients were r and omized in a ratio of 2:1 to a st and ard regimen using verteporfin therapy at a drug dose of 6 mg/m(2 ) body surface area and a light dose of 50 J/cm(2 ) or a sham treatment with placebo infusion and light exposure . Retreatments , if persistent fluorescein leakage from CNV was documented , were scheduled at 3-month intervals for up to 2 years . Confocal ICGA with tomographic sections was performed at baseline and continuously at the month 3 , 6 , 12 , and 24 examinations using a st and ardized protocol . MAIN OUTCOME MEASURES Analysis included the size of the neovascular net , the area of late hyperfluorescence , and choroidal hypofluorescence during early- and late-phase imaging . RESULTS In the verteporfin-treated group , the mean size of the CNV and the mean area of late leakage consistent with active leakage or staining showed no further enlargement at month 12 and were reduced at month 24 . In the placebo-treated group , new vessels grew threefold compared with baseline and exhibited persistent late hyperfluorescence result ing from leakage at 24 months . Associated choroidal hypofluorescence within the treated area was significantly increased in eyes treated with verteporfin PDT compared with the control group during the first year , persisted during all ICGA phases , and was irreversible during follow-up . Image analysis revealed choroidal hypoperfusion with choriocapillary dropout , which correlated with chorioretinal atrophy clinical ly . Progressive destruction of choroidal integrity by fibrosis in control eyes led to a similar extent of collateral hypofluorescence in both groups through the 24-month examination . CONCLUSIONS Indocyanine green angiography is an important adjunct in the identification of vascular effects associated with verteporfin PDT . Repeated treatments effectively arrested CNV growth and reduced leakage activity . The collateral impairment of choroidal perfusion appears to influence the visual outcome of the treatment OBJECTIVE To determine intraobserver and interobserver variation for classifying types of choroidal neovascularizations ( CNV ) in exudative age-related macular degeneration ( ARMD ) . DESIGN Intraexaminer and interexaminer reliability study . PARTICIPANTS  Digital high- quality fluorescein angiograms of 40 patients with neovascular ARMD were evaluated independently by 16 retinal specialists . MAIN OUTCOME MEASURES Fluorescein angiographies were presented in two r and omized sequences ( series A and B ) to each masked reader for classification of type of CNV into classic , occult , or mixed with classic component of less or greater 50 % . Agreement was evaluated by calculating kappa statistics ( kappa ) and intraclass correlation coefficients . RESULTS The mean kappa coefficient was 0.64 + /- 0.11 for intraobserver variation , with a range from 0.44 to 0.89 . For interobserver variation the intraclass correlation coefficients was calculated as 0.66 ( 95 % confidence interval [ CI ] 0.56 , 0.77 ) for series A and as 0.55 ( 95 % CI 0.43 , 0.67 ) for series B. CONCLUSIONS Angiographic classification of CNV secondary to ARMD can vary considerably not only between observers but also for repeated evaluation by the same observer . Because various current and emerging treatments including photodynamic therapy are based on specific angiographic characteristics , accurate interpretation will become more important OBJECTIVE To report 24-month vision and fluorescein angiographic outcomes from trials evaluating photodynamic therapy with verteporfin ( Visudyne ; CIBA Vision Corp , Duluth , Ga ) in patients with subfoveal choroidal neovascularization ( CNV ) caused by age-related macular degeneration ( AMD ) . DESIGN Two multicenter , double-masked , placebo-controlled , r and omized clinical trials . SETTING Twenty-two ophthalmology practice s in Europe and North America . PARTICIPANTS Patients with subfoveal CNV lesions caused by AMD with greatest linear dimension on the retina measuring 5400 micrometer or less , with evidence of classic CNV and best-corrected visual acuity ( approximate Snellen equivalent ) between 20/40 and 20/200 . METHODS The methods were similar to those described in our 1-year results , with follow-up examinations beyond 1 year continuing every 3 months ( except for Photograph Reading Center evaluations , which occurred only at month 18 and month 24 examinations ) . During the second year , the same regimen ( with verteporfin or placebo as applied at baseline ) was used if angiography showed fluorescein leakage from CNV . The primary outcome was the proportion of eyes with fewer than 15 letters ( approximately 3 lines ) of visual acuity loss at the month 24 examination , adhering to an intent-to-treat analysis . The last observation was carried forward to impute for any missing data . RESULTS Three hundred fifty-one ( 87 % ) of 402 patients in the verteporfin group compared with 178 ( 86 % ) of 207 patients in the placebo group completed the month 24 examination . Beneficial outcomes with respect to visual acuity and contrast sensitivity noted at the month 12 examination in verteporfin-treated patients were sustained through the month 24 examination . At the month 24 examination for the primary outcome , 213 ( 53 % ) of 402 verteporfin-treated patients compared with 78 ( 38 % ) of 207 placebo-treated patients lost fewer than 15 letters ( P<.001 ) . In subgroup analyses for predominantly classic lesions ( in which the area of classic CNV makes up at least 50 % of the area of the entire lesion ) at baseline , 94 ( 59 % ) of 159 verteporfin-treated patients compared with 26 ( 31 % ) of 83 placebo-treated patients lost fewer than 15 letters at the month 24 examination ( P<.001 ) . For minimally classic lesions ( in which the area of classic CNV makes up < 50 % but > 0 % of the area of the entire lesion ) at baseline , no statistically significant differences in visual acuity were noted . Few additional photosensitivity adverse reactions and injection site adverse events were associated with verteporfin therapy in the second year of follow-up . CONCLUSIONS The visual acuity benefits of verteporfin therapy for AMD patients with predominantly classic CNV subfoveal lesions are safely sustained for 2 years , providing more compelling evidence to use verteporfin therapy for these cases . For AMD patients with subfoveal lesions that are minimally classic , there is insufficient evidence to warrant routine use of verteporfin therapy OBJECTIVE To summarize findings from three r and omized clinical trials of krypton laser treatment of juxtafoveal neovascular lesions regarding changes in visual acuity during 5 years of follow-up , rates of persistent and recurrent choroidal neovascularization , and status of macular lesions 5 years after enrollment . DESIGN , PATIENTS , AND PRIMARY OUTCOME MEASURES : Follow-up of patients enrolled in three r and omized trials of choroidal neovascularization secondary to age-related macular degeneration ( AMD ) , ocular histoplasmosis , or idiopathic causes ended in March 1991 . All patients were eligible to complete at least 3 years of follow-up examinations . Data on visual acuity , reading vision , and anatomic outcomes during 5 years of follow-up were available for 276 ( 92 % ) of 300 patients with AMD , 236 ( 92 % ) of 256 patients with ocular histoplasmosis , and 38 ( 97 % ) of 39 patients with idiopathic choroidal neovascularization enrolled 5 or more years earlier who were still living . RESULTS Among eyes with AMD , the estimated relative risk ( RR ) of a loss of 6 or more lines of visual acuity from baseline to any examination from 6 months through 5 years after enrollment for untreated eyes in comparison with treated eyes was 1.20 ( P = .04 ) . Normotensive patients with AMD realized the greatest benefit from laser treatment ( RR , 1.82 ) and hypertensive patients experienced little or no benefit ( RR , 0.93 ) . Untreated eyes with ocular histoplasmosis were at much greater risk of a 6-line decrease in visual acuity from the 1-year through the 5-year examination than were treated eyes ( unadjusted RR , 2.60 ; RR , 4.26 after adjustment for visual acuity and hypertension at baseline ; P < .001 for both ) . The treatment effect for eyes with idiopathic choroidal neovascularization was between the effects for eyes with AMD and eyes with ocular histoplasmosis . CONCLUSIONS The early beneficial effects of laser treatment on visual acuity persisted for at least 5 years in eyes with all three underlying conditions . Laser treatment of similar eyes with choroidal neovascularization in a juxtafoveal location is recommended for patients with these conditions , with the caveat that hypertensive patients with AMD may fare no better with laser treatment than without treatment OBJECTIVE To report vision and safety outcomes from an extension of a 2-year investigation evaluating verteporfin photodynamic therapy in patients with age-related macular degeneration with subfoveal choroidal neovascularization ( CNV ) . DESIGN AND SETTING Open-label extension of selected patients from 2 multicenter , double-masked , placebo-controlled , r and omized clinical trials , the Treatment of Age-Related Macular Degeneration With Photodynamic Therapy ( TAP ) Investigation , at 22 ophthalmology practice s in Europe and North America . PARTICIPANTS Patients enrolled in the TAP Investigation and followed up for at least 24 months in whom verteporfin therapy to CNV might reduce the risk of further vision loss . METHODS Before receiving verteporfin therapy in the extension , eligible patients signed a written informed consent form accompanied by an oral consent process approved by local institutional review boards . Methods were similar to those described for 1- and 2-year results , with follow-up examinations beyond 2 years continuing at 3-month intervals with a few exceptions , including that extension patients with fluorescein leakage from CNV were to receive open-label verteporfin therapy irrespective of their original treatment assignment . RESULTS Of 402 patients in the verteporfin group , 351 ( 87.3 % ) completed the month 24 examination ; 320 ( 91.2 % ) of these enrolled in the extension study . The enrolled participants included 124 (  
    Output:
    
Subgroup analyses suggest that the benefits may be confined to people with no occult choroidal neovascularisation .
REVIEW ER 'S CONCLUSIONS Photodynamic therapy in people with classic choroidal neovascularisation due to age-related macular degeneration is effective in preventing visual loss .
There is no evidence that photodynamic therapy is beneficial for people with evidence of occult choroidal neovascularisation .