Index

Adjuncts for AMD surgery,

calciumand magnesium-free retinal detachment solutions, 321–322

tPA, 319–321 Alzheimer’s disease,

deposition of APOE, 43 immune mechanism, 42–44 similar findings in AMD, 43

Age-Related Eye Disease Study (AREDS), geographic atrophy, 85

results of, 385–388 vitamins, 383–384

Age-related macular degeneration (AMD), definitions, 364

epidemiology (see Epidemiology) exudative (see also Choroidal

neovascularization) clinical features, 104 epidemiology, 102 fellow eye, 103 history, 101

risk of (see Drusen, risk of CNV) nomenclature, 102

nonexudative (dry) AMD, 67–78 Amsler grid, 78

Beaver Dam Eye Study, 15, 67, 77 Chesapeake Bay Waterman, 67, 77 clinical features, 67–78

definition, 67 drusen (see Drusen) epidemiology, 68

geographic atrophy, 77 (see also Geographic atrophy)

risk factors, 68–70, 102, 366–378 age, 69, 102, 366

alcohol, 388 cardiac/cardiovascular, 374–377 drusen, 103

[Age-related macular degeneration (AMD)] environmental influences, 70

family history, 69, 102, 368–370 gender, 366–367

hyperopia, 69, 374 hypertension, 69, 375–376 hypercholesterolemia, 69 iris color, 371

nutrition, 70, 382–388 photic injury, 70

race, 69, 102, 367 sex, 69 socioeconomic, 370

smoking, 102, 379–381 sunlight, 381–382

Age-Related Macular Degeneration Radiation Trial (AMDRT), 233

Amsler grid, 78, 104 Angiogenesis, 21

antiangiogenic factors, 268 choroidal vs. retinal, 268–269 hypoxia, 268–269 proangiogenic factors, 267 processes, 268

Alpha-Tocopherol Beta-Carotene (ATBC) Cancer Prevention Study, 383

Antioxidants, 379, 382–388 Atherosclerosis, 375

immune mechanism, 39–42 of retinal vessels, 6

Atherosclerosis Risk in Communities Study, 368

ATX-S10, 220

Autoimmunity, antigen trapping, 38 definition, 38 desequestration, 38

molecular mimicry, 38 neoantigens, 38

534

Balanced Salt Solution (BSS), 321 Baltimore Eye Survey, 367

Baltimore Longitudinal Study on Aging (BLSA), 383–384

Barbados Eye Study, 366, 367 Basal lamina, 9

Basal laminar deposits, definition of, 16

Basal linear deposit, definition of, 16

Basophils, 33

Beaver Dam Eye Study, 15, 67, 77, 85, 89, 366, 370, 371, 373, 374, 375, 377, 379, 380, 382 385, 388, 463

Beta-carotene, 382–388 Blood-retinal barrier, 6

Blue Mountains Eye Study, 85, 366, 369, 371, 373, 375, 376, 377, 378, 380, 384, 385, 388, 464

BPD-MA (Benzoporphyrin Derivative Monoacid, Verteporfin, Visudyne),

half-life, 208

vascular occlusion, 208–209 Bruch’s membrane,

anatomy, 16, 325 aging, 9 calcification, 18

inner collagenous layer, 16 outer collagenous layer, 16

Calcium and magnesium free retinal detachment solutions, 321–322

Cancer-associated retinopathy, laser of, 76, 328–339 anti-RPE autoimmunity, 49

CARET study, 383 Carotenoids, 382–383 Cataract surgery,

and AMD, 372–373 Cathepsin D, 8

Cell culture,

retinal pigment epithelium, 7

Chesapeake Bay Waterman Study, 67, 77, 382 Choriocapillaris atrophy, 496–497 Chloroaluminum Sulfonated Phthalocyanine

(A1PcS4), 219

Choroidal neovascularization (CNV), 67 classic CNV (pathology of), 23 clinical trials,

MPS, 113–120, 181–185, 226 TAP study, 211–213

VIP study, 213, 220

Index

[Choroidal neovascularization (CNV)] fibrovascular PED (FVPED), 112 fluorescein angiographic features, 112 follow-up post-laser, 120

geographic atrophy and, 90 histopathology,

early, 19 late, 20

surgical specimens, 21 ICG angiography of, 134–141 laser treatment, 117–120

late leakage of undetermined source, 112 natural history, 115–116

occult, 120

natural history, 120, 260 pathology of, 23

risk of developing classic, 120–121 pathogenesis of, 114, 269–270 persistent vs. recurrent, 117, 183 pharmacological therapy, 270–271 recurrent, 185–187

risk of fellow eye, 389–393

risk of progression to CNV, 393–395 subfoveal,

MPS subgroups, 116, 187–188 treatment of,

minimally classic, 221 occult only, 220

predominantly classic, 212–213 type I vs. type II, 21

Choroidal neovascularization recurrence, histological predictor, 23, 185–187

Choroidal neovascular membrane, removal of (see Subretinal surgery)

Clinical research trials, design, 525

forms, 527–528 informed consent, 526 IRB, 526

limitations, 529

manual of procedures, 527–528 MPS, 524

methodology, 524–525 protocol, 526

risks, 526–527 safety (DSMC), 530

Clinical trials (see also separate entries for specific clinical trials)

randomized multicenter, 525 CNVPT, 332–338

techniques, 333 results, 333–338

Index

Complement, activation, 29

activation pathways, 30 alternative, 30 classic, 30

lectin, 30

Complications of Age-Related Macular Degeneration Prevention Trial (CAPT), 339, 351

Contrast enhancement, 427 Corpora amylacea, 4 Cortical implants, 443–444 Corticosteroids,

AMD treatment, 48, 52 Cytokines, 29–31

Dendritic cells, 33 Digital imaging, 133

digital subtraction ICG, 163 ICG angiography (see ICG)

Diskiform scar, 114 pathology, 21

Doyne honeycomb retinal dystrophy, 479 Driving, 425–426

Driving and geographic atrophy, 93 Drusen, 70

anatomy

basal laminar, 72–73 calcification of, 18 composition of, 326 crystalline, 74 disappearance of, 76 hard, 15, 71 high-risk, 74

laser of, 76, 328–339, 345, 352 natural history, 76, 327 regression/resorption of, 18, 328–339 risk of CNV, 326–327

soft, 18, 74 types, 71, 326

Dry AMD (see Nonexudative AMD)

ECM, 268 Embryology,

choroidal tissue, 1, 6 retina, 1, 2 vasculature, 6

Endostatin, 271

Epidemiology, AMD, 15, 325

geographic atrophy, 85

535

[Epidemiology] prevalence, 67

studies, definitions of, 355 case control, 356–357 cross-sectional, 358–360 prospective cohort, 361

Extracellular matrix (ECM), 7 Eye, 1

ganglion cells, 4, 9, 446 lysosomal system, 8

neurosensory retina (see neurosensory retina)

photoreceptor, 5

retinal pigment epithelium, 7, 9 retinal vessels, 6

Eye Disease Case Control Study (EDCCS), 370, 372, 374, 375, 376, 378, 379, 382, 384, 385, 388

Feeder vessels, 114 angiography of, 242 definition of, 242

ICG angiography of, 163 mechanism of action, 248–253 treatment of, 163

history of, 239–241

ICG dye enhanced, 239–241 Fellow eye,

risk of CNV, 389–393

Fibroblast Growth Factor (FGF-2), 269 Fluorescein angiography,

advantage over ICG, 147 Fovea,

structure, 5

Foveal avascular zone, 7 hypofluorescence, 8

Framingham Eye Study, 366, 372, 375 France DMLA, 372–373, 374, 380 Free radicals, 29, 31, 383

Genetics of AMD,

ABC transporters, 474 ABCA4 (ABCR), 473–478

Apoprotein E (apoE) gene, 481–482 ARMD 1, 469, 471

association analysis, 468 candidate gene analysis, 473–482 EFEMP1, 479

ELOVL4, 478, 480 epidemiology,

heredity, 458–467

536

[Genetics of AMD]

family aggregation studies, 462–465 gene therapy, 483–484

linkage analysis, 467, 469– 473 LOD score, 469

molecular biology, 467–484 peripherin/RDS gene, 480

population prevalence studies, 461–462 TIMP3, 480

twin studies, 459–460, 465–467 VMD2, 479

Geographic atrophy (GA), 83 Age-Related Eye Disease Study

(AREDS), 85 Beaver Dam Study, 89 bilaterality of, 89 clinical features, 83 CNV, risk of, 90 contrast sensitivity, 91 dark adaptation, 90, 92 differential diagnosis, 94 driving, 93 epidemiology, 85

fellow eye, 89, 90 genetics, 86 hemorrhage, 84 legal blindness, 85 low vision, 93 natural history, 86 pathology of, 19 peripapillary, 84 reading, 88, 93 risk factors, 85

antacids, 85 smoking, 85

thyroid hormones, 85 scotomas, 91–92 treatment, 95

visual impairment, 90–91 xanthophyll in, 84

Giant cells,

in diskiform scars, 21, 48 Glomerular disease

drusen, 47

immune mechanism, 44–47 similarity to AMD, 47

Hemorrhagic detachment Histopathology, 15–24 Hypofluorescence,

of fovea, 8 of macula, 8

Index

Idiopathic polypoidal choroidal vasculopathy, ICG angiography of, 138, 140, 156, 158, 161 vs. CSR, 161

Immune complex, 36 Immune mechanism of AMD,

macrophage-mediated innate immunity, 48 Immunology,

adaptive, 28 trigger, 37

innate, 28 trigger, 37

Indocyanine green angiography (ICG) clinical applications, 143–147 CNV, 24, 134, 193

hot spot, 137–138, 147 marginal spot, 138, 147 occult CNV, 113, 134–135 overlying spot, 138, 147 PED, 134–136, 151 plaque, 138, 147 polypoidal CNV, 138, 140 recurrent CNV, 138, 140

retinal-choroidal anastomosis (RCA), 138, 140, 153

Indocyanine green dye, advantages of, 131 history of, 132 toxicity, 133

vs. fluorescein dye, 131, 132

Indocyanine green (ICG) laser treatments, 192 ICG-guided laser,

occult CNV, 193–195 recurrent CNV, 156 treatment of CNV, 147

treatment of CNV with PED, 153 Interferon2a, 268 Interphotoreceptor matrix, 7

Interphotoreceptor retinoids binding protein (IRBP), 7

Iris color, 371–372

Lange’s fold, 2

Laser photocoagulation, 183 effect on retina, 327–328 extrafoveal, 183

for CNV, 183, 185 annular, 191–192 grid, 192

juxtafoveal, 183 subfoveal, 184 treatment of,

drusen (see Drusen, laser of)

Index

[Laser photocoagulation]

occult lesions, 188–189, 192 PED, 190

Laser-targeted drug delivery, 219 Legal blindness, 421

Light energy, 206 delivery of, 210

Limited macular translocation complications, 312–314 imbricating sutures, 300, 304

median postoperative foveal displacement, 296

minimum desired translocation, 294 operative technique, 297–306 outcomes, 311–312

patient selection, 292–293 postoperative laser, 308–311 postoperative positioning, 307–308 postoperative sensory adaptation, 311 recurrent CNV, 311

repeat translocation, 311 Lipofuschin, 4, 9

composition, 9 oxidative damage, 9

Low vision,

bioptic telescope, 425, 432 contrast enhancement, 427 devices, 429–438 evaluation, 421–428

glare reduction, 427, 435–436 telescopic devices, 431–433

Lutein (see Macular pigment)

Lutium texaphyrin (see Motexafin lutetium) Lymphocyte,

B cells, 35, 37 T cells, 34, 37

Macrophages, 32

Macular Photocoagulation Group, definitions, 113

Macular Photocoagulation Study (MPS), 113, 181

eligibility criteria, 182 extrafoveal CNV, 117 juxtafoveal CNV, 118

natural history of (see Choroidal neovascularization)

standard, 185

subfoveal CNV, 119–120

treatment of (see Laser photocoagulation) Macular pigment,

lutein, 2, 372, 383

537

[Macular pigment,) zeaxanthin, 2, 372, 383

Macular scotoma, 428–429 Macular translocation surgery,

combined with submacular surgery, 291 full vs. limited, 290

history of, 291–292 rationale, 291

retinal detachment enhancing solutions, 321–322

Maryland Waterman Study, 367 Mast cells, 33

Matrix metalloproteinase (MMP), 7 Melanin, 8

Melton Mowbray Eye Study, 367, 370, 371 Membrane,

external limiting, 3 internal limiting, 3, 4

Monocytes, 32, 51

Mono-L-Aspartyl Chlorin e6 (Npe6 or MACE), 218

Motexafin lutetium (Optrin, Lu-Tex), 204–205, 217

Nerve Fiber Layer of Henle, 5

Neurosensory retina, amacrine cell, 3, 5 bipolar cell, 3, 4, 5 ganglion cell, 3, 4, 5 ganglion cell layer, 446 horizontal cell, 3

inner nuclear layer, 446 Muller cell, 3, 5

nerve fiber layer, 3, 4

inner plexiform layer 3, 4 outer plexiform layer, 3

NHANES Studies, 366, 368, 370, 371, 373, 374, 377, 380, 384–385, 388

Npe6 (MACE), 218

Occult CNV

natural history, 120, 260

risk of developing classic, 120–121 Optical Coherence Tomography, 171

exudative AMD, 174–179 CNV, 176–179

PED, 174–176 normal retina, 172 nonexudative AMD, 173 vs. ultrasound, 171

538

Oxidative Damage

aging, 9

PED, 84, 104, 109 flattening, 111 risk of CNV, 111

PED with CNV treatment of, 151

PEDF, 271–272 Pericyte, 6

Phi-motion angiography, 243 Photodynamic therapy (PDT) (see also

Verteporfin), 122, 195 advantage of, 210

endothelial cell destruction, 204 history of, 203

light energy, 206 photochemical process, 207 singlet oxygen, 206

TAP, 122

vascular occlusion, 205 VIP, 122

Photon, 206 Photoreceptor

secondary degeneration, 19 Photoreceptor cell

aging, 5, 6 disk, 6, 8

inner segment, 3, 7, 8 outer segment, 3, 7, 8

Photosensitizers, 203, 206–210 accumulation of, 204 characteristics of, 206

POLA, 380 Porphyrins, 207

BPD-MA (benzoporphyrin derivative monoacid ring A), 207

chemical structure, 207–208 Preferred retinal locus (PRL), 91, 93,

428–429

Quality-of-Life Assessment, 511–520 ADVS, 516, 520

DLTV, 520

functional outcome, 515 MCS, 514–519 NEI-VFQ, 516–519 PCS, 514, 518

SF12, 515

SF36, 512–515, 518 VF-14, 513–520 WCS, 513–514, 518

Index

Radiation, 122 Radiation therapy, 227

AMDRT, 233

clinical studies, 229–233 proton beam, 231–232 rationale of, 227 toxicity of, 229

Retina,

embryology, 1, 2 (see embryology) Retinal-choroidal anatomosis, 138, 140, 153 Retinal circulation, 6

Retinal degeneration, 49 Retinal layers,

inner nuclear, 4 inner plexiform, 5

neurosensory (see Neurosensory retina) outer nuclear, 5

outer plexiform, 5

Retinal pigment epithelium (RPE), aging of, 326

anatomy, 7 detachment (see PED) flattening of, 84 oxidative injury, 50

Retinal prosthesis, 444–451 ganglion cell layer, 446 inner nuclear layer, 446

Retinal translocation (see also macular translocation), 123

Rotterdam study, 366, 369, 375, 377, 464 Rhodopsin, 5

RPE apoptosis, 501 RPE transplantation,

binding to Bruch’s membrane, 500–501 cell sources, 503

clinical results, 498–499 fetal RPE cells, 503 immune suppression, 503

problems in AMD Bruch’s membrane, 502–504

rationale for use, 494 RPE harvesting, 497

Sattler’s layer, 243–248

Scanning laser ophthalmoscope (SLO), 91 Singlet oxygen, 206

SLO,

and feeder vessel treatment, 241 macular perimetry, 428–429

Submacular surgery, 494–496 complications, 285

history of, 277

Index

[Submacular surgery] non-AMD, 284–285 non-subfoveal, 285 patient selection, 278 SST, 284, 286 technique, 279–281 visual results, 283

Submacular surgery trial (SST), 284, 286 histopathology results, 23

Subretinal neovascular membrane (see choroidal neovascular membrane)

Subretinal surgery (see also SST),

of choroidal neovascular membrane, 15

TAP study, 211–212 adverse events, 212

recommendations, 212–213 visual outcomes, 211–212

Tin ethyl etiopurpurin (Purlytin, SnET2), 209, 217

Tissue inhibitor of metalloproteinase (TIMP), 7

tPA, 319–321

anterior chamber usage, 319 mechanism of action, 319 toxicity, 320

use in subretinal hemorrhage, 320 vitreous injection, 320

539

Transpupillary thermotherapy (TTT), 122 adverse events, 262–263

clinical trials, 261–262 mechanisms of action, 263 methods, 263

VEGF,

animal experiments, 269–270 anti-VEGF therapy, 270

Verteporfin (Visudyne) (see also BPD-MA)

adverse events, 212

clinical trials results, 210–213 TAP study, 211–212

VIP study, 213, 220 Visual loss,

psychosocial aspects, 407–419 visual rehabilitation, 416–417

Vitamins, 103

AREDS doses, 382–388 betacarotene, 383–384

Xanthophyll, 196

Zeaxanthin (see Macular pigment)

Zinc, 385–388