To determine if there is a rationale for monitoring patients with age-relatedmacular degeneration who have a minimally classic subfoveal choroidal neovascularlesion and do not receive treatment at initial examination.
Participants assigned to placebo who had a minimally classic lesioncomposition at baseline were identified from the TAP Investigation. Fluoresceinangiograms at baseline and follow-up examinations from these participantswere reviewed by photograph reading center graders to determine if any follow-upangiograms had converted from a minimally classic lesion composition to apredominantly classic lesion composition.
Main Outcome Measures
Proportion of minimally classic lesions at baseline that converted toa predominantly classic lesion composition, time of this conversion, and visualacuity and lesion size at the time of conversion.
Of the 207 patients assigned to placebo in the TAP Investigation, 98were judged to have a minimally classic lesion at baseline in the study eyewhen the fluorescein angiograms were reviewed in 2001. Of these 98 patients,39 (40%) had lesions that converted to a predominantly classic lesion composition,including 21 by the month 3 examination. At the time of conversion, 32 (82%)lesions were no greater than 9 disc areas, including 20 (51%) with visualacuity of 20/200 or better.
These data would suggest that patients with minimally classic lesions,in whom no therapy is recommended initially, should be monitored so that potentialconversion to a predominantly classic lesion can be identified promptly andverteporfin therapy considered.