Preface

Retinal Pharmacotherapy has been chosen as the title of this new Book in order to elucidate its dual focus – pharmacology of drugs and therapy of vitreoretinal diseases. It is among the very first books in the field to address the very rapid development of pharmacotherapy, thereby filling the need for a comprehensive reference to aid clinician scientists, retina specialists, and comprehensive ophthalmologists in managing patients and conducting studies.

There have been significant developments and advances in the therapy of vitreoretinal diseases in recent years. Although much progress is still needed, ocular diseases such as age-related macular degeneration, diabetic macular edema, and retinal vein occlusions may now be managed by newly discovered or re-discovered drugs such as corticosteroids or specific monoclonal antibodies. Retinal Pharmacotherapy aims to present updated data on the currently existing and upcoming drugs that are employed to treat the many vitreoretinal disorders. We have designed a book that would serve as a reference with basic understanding of retinal physiology and provide information on how certain drugs or classes of drugs may work – how small interfering RNAs aid in the control of angiogenesis and why anti-vas- cular endothelial growth factor may be effective, among others. The Book also provides a basic framework for new concepts and drugs in the treatment of retinal diseases as well as allowing an understanding of the principles of ocular pharmacotherapy in the retina. It will also facilitate better understanding of novel drugs such as monoclonal antibodies and aptamers (pegaptanib, ranibizumab, bevacizumab, and others). In addition, the Book presents detailed information on the techniques and methods of ocular drug delivery such as intravitreal injections and sustained-release delivery devices.

Throughout the 53 chapters, we have looked at pharmacologic therapies from different points of view with the assistance of authors who are authorities on the topics and who are capable of providing the readers with state-of-the-art information. The Book is divided into major sections including Retinal Molecular Biology, Animal Models and Routes for Retinal Drug Delivery, Retinal Diseases Amenable to Pharmacotherapy, Drugs and Mechanisms and Retinal Diseases, Pharmacotherapy and Surgery, and the Last Words. In “Retinal Molecular Biology,” various aspects such as biochemistry, molecular biology, and retinal morphology are presented in great depth as the basis for further comprehension of therapeutic pharmacologic agents. “Animal Models and Routes of Retinal Drug Delivery” presents basic information about animal models employed for research on potential

therapeutic agents as well as novel concepts in various routes for retinal drug delivery. In “Retinal Diseases Amenable to Pharmacotherapy,” the authors describe retinal diseases that may benefit from phar­ macologic approaches in clinical practice. The various chapters in “Drugs and Mechanisms and Retinal Diseases” review different drugs currently used in patients with retinal diseases. The section “Pharmacotherapy and Surgery” illustrates the importance of procedures such as radiotherapy in conjunction with pharmacologic agents. Retinal Pharmacotherapy concludes with “The Last Words” where processes to obtain FDA approval, evidence-based medicine, and various therapeutic agents that are in the pipeline for selective diseases such as AMD and DME, are discussed in great detail.

In conclusion, we hope that the Book will bring the ophthalmic scientific community to the frontline of research, diving into diseases of the retina, and will challenge scientists in academia and the phar­ maceutical industry to develop innovative strategies for the translation of investigative products into viable therapeutics. Certainly, Retinal Pharmacotherapy would not have been successfully produced without the many wonderful colleagues throughout the world who devoted their time and efforts in sharing their expertise in the many chapters. In addition, throughout the many months that were required to bring forth the first edition of Retinal Pharmacotherapy, our task was greatly assisted by Mr. Russell Gabbedy, Ms. Alexandra Mortimer, and Mr. Sven Pinczewski of the Editorial Staff at Elsevier, who encouraged and guided us, and occasionally pressured us to meet the various deadlines (and we are so glad they did) during the process, from the time we brought to them the concept of the Book to the time Retinal Pharmacotherapy was made available for your use; we certainly owe them our deepest gratitude. Finally, we would like to thank you – our readers and most impartial judges. As this is the first edition of the Book, we are certain that there may be many imperfections. Please kindly share them with us so that the second edition will be more to your satisfaction. Given the lightning rate of progress, we expect to work on the revised edition of Retinal Pharmacotherapy very soon!

Quan Dong Nguyen, MD, MSc

Eduardo Büchele Rodrigues, MD

Michel Eid Farah, MD

William F. Mieler, MD

–  To my parents, Dr. and Mrs. Dong So Nguyen, and my three brothers, Dr. Phong Dong Nguyen, Dr. Chau Dong Nguyen, and Chuong Dong Nguyen, Esquire, for their constant support and encouragement. Through their devotion, I have learned compassion and humility – I am profoundly indebted.

–  To my teachers, especially Mrs. Laura Bushar, Dr. Lynda Beck, Mrs. Linda Haskins, Dr. Helen Davies, Dr. George L. Spaeth,   Dr. Stuart L. Fine, Dr. C. Stephen Foster, Dr. Charles L. Schepens, Dr. Morton F. Goldberg, and Dr. Peter A. Campochiaro, for their

mentorship and guidance. They have guided me along every step, pushed me to my maximum ability, and championed me throughout my career. Without their direction and counsel, I would not have been able to achieve my dreams – I am respectfully grateful.

–  To my colleagues, fellows, residents, medical students, and patients, for the challenges they persistently present to me. Together, they bestow upon me the confidence to be the best physician for my patients and the most productive clinician scientist for my profession – I pay them homage.

–  Finally, to my wife, partner, and colleague, Dr. Diana Do, for her unconditional love and support, and for her willingness to stand by me throughout the successful as well as the most challenging times. – I owe her so much.

Quan Dong Nguyen

–  To my three sons, Michael, Andrew, and Daniel, who understand the value and significance of quality education and hard work

–  To the numerous residents and vitreoretinal fellows who continue to ask questions and stimulate all of us to obtain better answers to challenging issues

–  To my numerous national and international colleagues for their long-standing support and friendship

–  Finally, to Jennifer, who is a uniquely wonderful, special, and talented individual. We make a great team

William F Mieler