Photodynamic therapy of subfoveal choroidal neovascularization with verteporfin: fluorescein angiographic guidelines for evaluation and treatment--TAP and VIP report No. 2

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. 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 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 materials forwarded to the Wilmer Photograph Reading Center were reviewed by masked graders. 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. 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. 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

Engineering Multi-agent Systems Anno 2025

Modern software-intensive systems are increasingly blending cyber, physical, and social elements, demanding higher degrees of autonomy and adaptability than ever before. In combination with the ever growing integration and scale of systems, and the inherent uncertainties modern systems face, the principles from MAS engineering remain particularly attractive for engineering systems in a wide variety of domains today. In this chapter, we reflect on the role and potential of MAS engineering on a selection of key facets that characterize modern software engineering practice. We focus at facets that we believe are important in relation to MAS engineering. Concretely, we look at agile development, Cloud and edge computing, distributed ledgers and blockchain, Cyber-Physical Systems and Internet-of-Things, and finally green computing. For each of these facets we highlight opportunities to EMAS engineering, but also the challenges these facets raise. We conclude with highlighting a number of ethical issues that the engineers of modern software-intensive systems and thus also MAS will face in the years to come