- •Foreword
- •Preface
- •Contents
- •Contributors
- •Key Points
- •Introduction
- •Etiology
- •A Genetic Cause
- •Family Studies
- •Associations with Race
- •Specific Genes Conferring AMD Risk
- •Complement Factor H
- •C2-CFB Locus
- •Complement Component 3
- •Other Inflammatory Factor Variants
- •Toll-Like Receptor
- •VEGF-A
- •Genetic Variants on Chromosome 10q26
- •LOC387715/ARMS2
- •HTRA1
- •Other Genetic Variants
- •Apolipoprotein E
- •Fibulin 5
- •Hemicentin-1
- •LOC387715/HTRA1 and CFH
- •Genetic Predisposition to a Specific Late Phenotype
- •Conclusion
- •References
- •Key Points
- •Introduction
- •Smoking
- •Alcohol
- •Increased Light Exposure
- •Obesity
- •Exercise
- •Dietary Fat Intake
- •Phytochemicals
- •Ginkgo Biloba
- •Anthocyanins
- •Resveratrol
- •Epigallocatechin Gallate
- •Mineral Supplements
- •Summary
- •References
- •Key Points
- •Introduction
- •Classification
- •Nonexudative (Non-neovascular or Dry) AMD
- •Exudative (Neovascular or Wet) AMD
- •Retinal Angiomatous Proliferation
- •Polypoidal Vasculopathy
- •Diagnosis
- •Differential Diagnosis
- •Nonexudative AMD
- •Central Serous Chorioretinopathy (CSCR)
- •High Myopia
- •Stargardt’s Disease/Fundus Flavimaculatus
- •Cuticular Drusen
- •Pattern Dystrophy
- •Old Exudative AMD
- •Old Laser Scars
- •Other Conditions
- •Exudative AMD
- •Central Serous Chorioretinopathy
- •Idiopathic Polypoidal Choroidal Vasculopathy
- •Retinal Angiomatous Proliferation (RAP)
- •Presumed Ocular Histoplasmosis Syndrome (POHS)
- •Angioid Streaks
- •High Myopia
- •Cystoid Macular Edema
- •Traumatic Choroidal Rupture
- •Macular Hemorrhage
- •CNV Secondary to Laser
- •Idiopathic
- •Summary
- •References
- •Key Points
- •Introduction
- •Color Photography
- •Monochromatic Photography
- •Autofluorescence Imaging
- •Optical Coherence Tomography
- •Enhanced Depth Imaging
- •Fundus Angiography
- •Fluorescein Dye Characteristics
- •Indocyanine Green Dye Characteristics
- •Cameras and Angiography
- •Patient Consent and Instruction
- •Fluorescein Injection
- •Fluorescein Technique
- •Indocyanine Green Technique
- •The Macula
- •Deviations from Normal Angiographic Appearance
- •Indocyanine Green Angiographic Interpretation
- •Drusen
- •Choroidal Neovascularization
- •CNV and Fluorescein Angiography
- •Retinal Vascular Contribution to the Exudative Process
- •Fundus Imaging Characteristics of Therapies for Neovascular AMD
- •Thermal Laser
- •Photodynamic Therapy
- •Anti-VEGF Therapy
- •References
- •Key Points
- •Introduction
- •AREDS
- •Carotenoids
- •Beta-Carotene
- •Macular Xanthophylls
- •Fatty Acids
- •Vitamin E
- •Vitamin C
- •Zinc
- •Folate/B-Vitamins
- •AREDS2
- •Summary
- •References
- •6: Management of Neovascular AMD
- •Key Points
- •Introduction
- •Angiogenesis
- •An Overview of VEGF
- •VEGF-A Isoforms
- •VEGF-A Physiological Response
- •VEGF-A Response in Retinal Diseases
- •Antiangiogenic Drugs
- •Pegaptanib
- •Drug Overview
- •Published Trials
- •Bevacizumab
- •Drug Overview
- •Published Studies
- •Ranibizumab
- •Drug Overview
- •Published Trials
- •Safety Data
- •Upcoming Clinical Trials
- •Promising VEGF Inhibitors
- •Conclusion
- •References
- •Key Points
- •Introduction
- •Antinflammatory Therapy
- •Verteporfin Angioocclusive Therapy
- •Antiangiogenic Therapy
- •Rationale for Combination Therapy in the Treatment of Exudative AMD
- •Clinical Data Examining Combination Therapy for Exudative AMD
- •Verteporfin Therapy in Combination with Triamcinolone
- •Verteporfin PDT Therapy in Combination with Anti-VEGF Agents
- •Triple Therapy for Exudative Age-Related Macular Degeneration
- •Summary
- •References
- •Key Points
- •Drusen
- •Geographic Atrophy
- •Imaging Modalities in Dry AMD
- •Clinical Trials for Dry AMD
- •Study Design
- •Risk Reduction in Dry AMD
- •AREDS
- •Laser/CAPT
- •Anecortave Acetate
- •Control of Disease Progression
- •Visual Cycle Inhibition: Antioxidants
- •Antioxidants
- •Complement
- •Neuroprotective Agents
- •Modulators of Choroidal Circulation
- •Recovery
- •Gene Therapy
- •Stem Cell Therapy
- •Retinal Prostheses
- •Summary
- •References
- •Key Points
- •Introduction
- •Emerging and Future Therapies
- •Ranibizumab
- •Bevacizumab
- •VEGF Trap-Eye
- •Bevasiranib
- •Vatalanib
- •Pazopanib
- •Sirna-027
- •Anti-VEGFR Vaccine Therapy
- •Radiation
- •Epi-Rad90™ Ophthalmic System
- •IRay
- •Infliximab
- •Sirolimus
- •Gene Therapy
- •AdPEDF.11
- •AAV2-sFLT01
- •Other Pathways
- •Squalamine Lactate
- •Combretastatin A4 Phosphate/CA4P
- •Volociximab
- •NT-501, Ciliary Neurotrophic Factor
- •Sonepcizumab
- •Summary
- •References
- •Key Points
- •Introduction
- •Evidence-Based Medicine
- •Interventional Evidence
- •Masking
- •Dropout Rate
- •Validity
- •Risk Reduction
- •Pharmacoeconomic Analysis
- •Cost-Minimization Analysis
- •Cost-Benefit Analysis
- •Cost-Effectiveness Analysis
- •Quality-of-Life Instruments, Function-Based
- •Quality-of-Life Instruments, Preference-Based
- •Utility Acquisition
- •Utility Gain
- •Decision Analysis
- •Comparative Effectiveness (Human Value Gain)
- •Value Trumps Cost
- •Costs
- •Cost Basis
- •Cost Perspective
- •Cost-Utility Ratio
- •Cost-Effectiveness Standards
- •Discounting
- •Standardization
- •Patient Respondents
- •Cost Perspective
- •The Future
- •Macroeconomic Costs and AMD
- •Employment and Wage Loss
- •Gross Domestic Product (GDP)
- •Other Costs
- •Financial Return on Investment (ROI)
- •References
- •Index
Contents
1 |
Genetics of Age-Related Macular Degeneration...................... |
1 |
|
Daniel T. Kasuga, Yuhong Chen, and Kang Zhang |
|
2 |
Modifiable Risk Factors of Age-Related |
|
|
Macular Degeneration................................................................ |
15 |
|
Hanna R. Coleman |
|
3 |
Diagnosis of Age-Related Macular Degeneration .................... |
23 |
|
Jonathan Jonisch and Gaurav Shah |
|
4 |
Fundus Imaging of Age-Related |
|
|
Macular Degeneration................................................................ |
39 |
|
Allen Chiang, Andre J. Witkin, Carl D. Regillo, |
|
|
and Allen C. Ho |
|
5 |
Therapy of Nonexudative Age-Related |
|
|
Macular Degeneration................................................................ |
65 |
|
Annal D. Meleth, Veena R. Raiji, Nupura Krishnadev, |
|
|
and Emily Y. Chew |
|
6 |
Management of Neovascular AMD ........................................... |
79 |
|
Fernando M. Penha and Philip J. Rosenfeld |
|
7 |
Combination Therapy with Ocular Photodynamic |
|
|
Therapy for Age-Related Macular Degeneration .................... |
99 |
|
Nathan Steinle and Peter K. Kaiser |
|
8 |
The Future of Non-neovascular Age-Related |
|
|
Macular Degeneration................................................................ |
119 |
|
Ketan Laud, Sri Krishna Mukkamala, Claudia Brue, |
|
|
and Jason S. Slakter |
|
9 |
The Future of Neovascular Age-Related |
|
|
Macular Degeneration................................................................ |
135 |
|
Chirag P. Shah and Jeffrey S. Heier |
|
10 |
The Economics of Age-Related Macular Degeneration .......... |
155 |
|
Gary C. Brown, Melissa M. Brown, Heidi B. Lieske, |
|
|
Philip A. Lieske, and Kathryn Brown |
|
Index..................................................................................................... |
175 |
|
ix
Contributors
Gary C. Brown, M.D., M.B.A. Department of Ophthalmology,
Jefferson Medical College, Wyndmoore, PA, USA; Center for Value-Based Medicine, Flourtown, PA, USA
Kathryn Brown Center for Value-Based Medicine, Flourtown, PA, USA
Melissa M. Brown, M.D., M.B.A. Department of Ophthalmology, Jefferson Medical College, Wyndmoore, PA, USA; Center for Value-Based Medicine, Flourtown, PA, USA
Claudia Brue, M.D. URMNY, New York, NY, USA
Yuhong Chen, M.D., Ph.D. Department of Ophthalmology, University of California at San Diego, La Jolla, San Diego, CA, USA
Emily Y. Chew, M.D. Division of Epidemiology and Clinical Applications, National Eye Institute/National Institutes of Health, Bethesda, MD, USA
Allen Chiang, M.D. Retina Service, Wills Eye Institute/
Mid-Atlantic Retina, Philadelphia, PA, USA
Hanna R. Coleman, M.D. Department of Ophthalmology, New York Hospital Presbyterian-Columbia, New York, NY, USA
Jeffrey S. Heier, M.D. Ophthalmic Consultants of Boston, Boston, MA, USA
Allen C. Ho, M.D. Retina Service, Wills Eye Institute/Mid-Atlantic Retina, Philadelphia, PA, USA
Jonathan Jonisch, M.D. Barnes Retina Institute, MO, USA
Peter K. Kaiser, M.D. Cole Eye Institution, Cleveland Clinic, Cleveland, OH, USA
Daniel T. Kasuga, B.S. Department of Ophthalmology,
University of California at San Diego, La Jolla, San Diego, CA, USA
Nupura Krishnadev, M.D., FRCSC Department of Epidemiology and Clinical Applications, National Eye Institute/National Institutes of Health, Bethesda, MD, USA
Ketan Laud, M.D. Vitreous-Retina-Macula Consultants of New York, Columbia University, New York, NY, USA
xi
xii |
Contributors |
|
|
Heidi B. Lieske Center for Value-Based Medicine, Flourtown, PA, USA
Philip A. Lieske Center for Value-Based Medicine, Flourtown, PA, USA
Annal D. Meleth, M.D., M.S. Department of Epidemiology
and Clinical Applications, National Eye Institute/National Institutes of Health, Bethesda, MD, USA
Sri Krishna Mukkamala, M.D. Department of Ophthalmology,
The New York Eye and Ear Infirmary, New York, NY, USA
Fernando M. Penha, M.D., Ph.D. Department of Ophthalmology,
Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
Veena R. Raiji, M.D., M.P.H. Department of Ophthalmology,
George Washington University, Washington, DC, USA
Carl D. Regillo, M.D., FACS Retina Service, Wills Eye Institute/
Mid-Atlantic Retina, Philadelphia, PA, USA
Philip J. Rosenfeld, M.D., Ph.D. Department of Ophthalmology,
Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
Chirag P. Shah, M.D., M.P.H. Ophthalmic Consultants of Boston,
Boston, MA, USA
Gaurav Shah, M.D. Barnes Retina Institute, MO, USA
Jason S. Slakter, M.D. Vitreous-Retina-Macula Consultants
of New York, New York, NY, USA
Nathan Steinle, M.D. Cole Eye Institute, Cleveland Clinic Foundation,
Cleveland, OH, USA
Andre J. Witkin, M.D. Retina Service, Wills Eye Institute/
Mid-Atlantic Retina, Philadelphia, PA, USA
Kang Zhang, M.D., Ph.D. Department of Ophthalmology,
Institute for Genomic Medicine, Shiley Eye Center,
University of California at San Diego, La Jolla, San Diego, CA, USA
