Our Grading Services

We provide customised grading services for your clinical trials. Our fellowship-trained retinologists and certified graders provide grading services for various eye images including:

Fundus Fluorescein Angiography (FFA)

Indocyanine Green Angiography (ICGA)

Optical Coherence Tomography (OCT)

Quantitative and Qualitative

OCT Angiography (OCTA)

Color Fundus Photography (CFP)

Fundus Auto Fluorescence (FAF)

We employ the use of a 24-hour secure server and computers of high caliber and precision.

Project timeline

Step 1

Contact us for a discussion

Step 2

A customised imaging and grading protocol will be developed for your perusal

Step 3

Administrative preparation before the project commences

Step 4

Project

commences

Step 5

Project ends

On top of grading services, we also provide the following services:

Provision of standardised image capture protocols customised to the clinical trials’ requirements

Development of study and image grading protocols for clinical studies & clinical trials

Certification of study site ophthalmic photographers

Reception, time-stamping, cataloguing and archival of images

Organisational Structure

Our group of expert graders are fellowship-trained retinologists and certified graders who are well versed in the grading of FFA, ICGA, OCT, OCTA, CFP and FAF images.

They are supported by a team experienced with the Standard Operating Procedures (SOPs) of the Reading Centre and provides the administrative, IT and maintenance support in the daily operations of the FIRC.

The FIRC has served as the Central Reading Centre in a number of scientifically renowned clinical trials.

The EVEREST II Clinical Trial

A 24-month multicenter, randomized, double-masked study designed to compare the efficacy and safety profile of ranibizumab, 0.5 mg, and Verteporfin Photodynamic Therapy (vPDT) combination therapy with ranibizumab, 0.5 mg, monotherapy in 322 Asian participants with symptomatic macular PCV confirmed by the Central Reading Center using indocyanine green angiography. The study involved 42 sites in seven countries.

The EVEREST Clinical Trial

A multicenter, double-masked, primarily indocyanine green angiography-guided trial of 61 Asian patients with symptomatic macular polypoidal choroidal vasculopathy. Patients were randomized to verteporfin photodynamic therapy (PDT) (standard fluence), ranibizumab 0.5 mg, or the combination. The primary endpoint was the proportion of patients with indocyanine green angiography-assessed complete regression of polyps at Month 6. Secondary endpoints included mean change in best-corrected visual acuity at Month 6 and safety. The study involved seven sites from five countries.

Best Poster (Clinical / Epidemiology)

Macula Symposium Singapore 2017

Tan CS, Feller C, Margaron P, Lim TH

Evaluation of Polypoidal Choroidal Vasculopathy Lesions on Indocyanine Green Angiography in the First Year of the EVEREST II Study

PUBLICATIONS SUPPORTED BY FIRC

Tock H Lim, Timothy YY Lai, Kanji Takahashi, Tien Y Wong, Lee-Jen Chen, Paisan Ruamviboonsuk, Colin S Tan, Won Ki Lee, Chui Ming Gemmy Cheung, Nor Fariza Ngah, Ramune Patalauskaite, Philippe Margaron, Adrian Koh, EVEREST II Study Group

Comparison of Ranibizumab With or Without Verteporfin Photodynamic Therapy for Polypoidal Choroidal Vasculopathy: The EVEREST II Randomized Clinical Trial

JAMA Ophthalmol. 2020 Sep 1;138(9):935-942. doi: 10.1001/jamaophthalmol.2020.2443 PMID: 32672800; PMCID: PMC7366282

Colin S Tan, Louis W Lim, Wei Kiong Ngo, Pandiyan Pannirselvam, Clarence See, Wai Kitt Chee, Nakul Saxena

Predictors of Persistent Disease Activity following Anti-VEGF Loading Dose for nAMD Patients in Singapore: The DIALS Study

BMC Ophthalmol. 2020 Aug 6;20(1):324. doi: 10.1186/s12886-020-01582-y PMID: 32762659

Colin S Tan, Wei K Ngo, Louis W Lim, Nikolle W Tan, Tock H Lim

EVEREST Study Report 4: Fluorescein Angiography Features Predictive of Polypoidal Choroidal

Clin Exp Ophthalmol. 2019 Jul;47(5):614-620. doi: 10.1111/ceo.13464. Epub 2019 Feb 10. vasculopathy PMID: 30652395; PMCID: PMC6767036

Colin S Tan, Louis W Lim, Wei Kiong Ngo, Tock Han Lim, EVEREST Study Group

EVEREST Report 5: Clinical Outcomes and Treatment Response of Polypoidal Choroidal Vasculopathy Subtypes in a Multicenter, Randomized Controlled Trial

Invest Ophthalmol Vis Sci. 2018 Feb 1;59(2):889-896. doi: 10.1167/iovs.17-22683 PMID: 29435588

Adrian Koh, Timothy Y Y Lai, Kanji Takahashi, Tien Y Wong, Lee-Jen Chen, Paisan Ruamviboonsuk, Colin S Tan, Chrystel Feller, Philippe Margaron, Tock H Lim, Won Ki Lee, EVEREST II study group

Efficacy and Safety of Ranibizumab With or Without Verteporfin Photodynamic Therapy for Polypoidal Choroidal Vasculopathy: A Randomized Clinical Trial

JAMA Ophthalmol. 2017 Nov 1;135(11):1206-1213. doi: 10.1001/jamaophthalmol.2017.4030 PMID: 28983556; PMCID: PMC5710379

Colin S Tan, Wei Kiong Ngo, Louis W Lim, Nikolle W Tan, Tock H Lim, EVEREST Study Group

EVEREST Study Report 3: Diagnostic Challenges of Polypoidal Choroidal Vasculopathy. Lessons Learnt from Screening Failures in the EVEREST Study

Graefes Arch Clin Exp Ophthalmol. 2016 Oct;254(10):1923-1930. doi: 10.1007/s00417-016-3333-y. Epub 2016 May 3 PMID: 27142805; PMCID: PMC5045476

Colin S Tan, Wei Kiong Ngo, Jian Ping Chen, Nikolle W Tan, Tock Han Lim, EVEREST Study Group

EVEREST Study Report 2: Imaging and Grading Protocol, and Baseline Characteristics of a Randomised Controlled Trial of Polypoidal Choroidal Vasculopathy

Br J Ophthalmol. 2015 May;99(5):624-8. doi: 10.1136/bjophthalmol-2014-305674. Epub 2015 Mar 10 PMID: 25758601; PMCID: PMC4413842

Adrian HC Koh, Expert PCV Panel; Lee-Jen Chen, Shih-Jen Chen, Youxin Chen, Anantharam Giridhar, Tomohiro Iida, Hakyoung Kim, Timothy Yuk Yau Lai, Won Ki Lee, Xiaoxin Li, Tock Han Lim, Paisan Ruamviboonsuk, Tarun Sharma, Shibo Tang, Mitsuko Yuzawa

Polypoidal Choroidal Vasculopathy: Evidence-Based Guidelines for Clinical Diagnosis and Treatment

Retina. 2013 Apr;33(4):686-716. doi: 10.1097/IAE.0b013e3182852446 PMID: 23455233

Adrian Koh, Won Ki Lee, Lee-Jen Chen, Shih-Jen Chen, Yehia Hashad, Hakyoung Kim, Timothy Y Lai, Stefan Pilz, Paisan Ruamviboonsuk, Erika Tokaji, Annemarie Weisberger, Tock H Lim

EVEREST Study: Efficacy and Safety of Verteporfin Photodynamic Therapy in Combination with Ranibizumab or Alone versus Ranibizumab Monotherapy in Patients with Symptomatic Macular Polypoidal Choroidal Vasculopathy

Retina. 2012 Sep;32(8):1453-64. doi: 10.1097/IAE.0b013e31824f91e8 PMID: 22426346