- •Preface to the Second Edition
- •Contents
- •List of Abbreviations
- •1: Epidemiology of AMD
- •Core Messages
- •1.1 Introduction
- •1.3 Frequency
- •1.3.1 Prevalence
- •1.3.2 Incidence
- •1.4 Natural Course
- •1.5 Genetic Factors
- •1.5.1 The Complement Pathway Genes
- •1.5.1.1 Complement Factor H (CFH)
- •1.5.1.3 Complement Component 3 (C3)
- •1.5.1.4 Complement Factor I (CFI)
- •1.5.2 The ARMS2 (10q26) Locus
- •1.5.3.1 Apolipoprotein E (APOE)
- •1.5.4 Candidate Gene Association Studies
- •1.6 Environmental Factors
- •1.6.1 Smoking
- •1.6.2 Antioxidants
- •1.6.3 Body Mass Index (BMI)
- •1.6.4 Hypertension
- •1.6.5 Cataract Surgery
- •1.7 Interaction Between Risk Determinants
- •1.7.1 Combined Effects of CFH Y402H and Other Genetic and/or Environmental Factors
- •1.7.2 Combined Effects of 10q26 SNPs and Other Genetic and/or Environmental Factors
- •1.7.4 Combined Effects of the APOE Gene and Other Genetic and/or Environmental Factors
- •References
- •2: Genetics
- •Core Messages
- •2.1 Introduction
- •2.2 Identifying Risk Factors of a Common Disease
- •2.3 Early Findings
- •2.4.1 Functional Implications
- •2.5.1 Functional Implications
- •2.7 Prospects of Genetics in AMD Therapy and Prevention
- •Summary for the Clinician
- •References
- •Core Messages
- •3.1 Introduction
- •3.2 Cause and Consequences of Ageing
- •3.3 Clinical Changes Associated with Retinal Ageing
- •3.4 Ageing of the Neural Retina
- •3.5 Ageing of the RPE
- •3.5.1 Changes in RPE Cell Density
- •3.5.2 Subcellular Changes in the RPE
- •3.5.3 Accumulation of Lipofuscin
- •3.5.4 Melanosomes and Pigment Complexes
- •3.5.7 Antioxidant Capacity of the RPE
- •3.6 Ageing of Bruch’s Membrane
- •3.7 The Association Between Ageing and AMD
- •Summary for the Clinician
- •References
- •Core Messages
- •4.1 Introduction
- •4.2 The Complement System
- •4.3 Evidence for Involvement of the Complement System in AMD Pathogenesis
- •4.4.2 Complement Gene Variants and AMD Subtypes
- •4.4.3 Complement Gene Variants and Progression of AMD
- •4.4.5 Variations of Complement Genes and Response to Treatment: Pharmacogenetics
- •4.5 Emerging Pharmacological Intervention Targeting Complement Dysregulation
- •Conclusions
- •Summary for the Clinician
- •References
- •5: Histopathology
- •Core Messages
- •5.1 Retinal Pigment Epithelium
- •5.1.1 Structure and Function of the Retinal Pigment Epithelium
- •5.1.3 Deposits in the RPE
- •5.2 Bruch’s Membrane
- •5.2.1 Structure of Bruch’s Membrane
- •5.2.3 Deposits in Bruch’s Membrane, Drusen
- •5.3 Choroidal Neovascularization
- •5.4 Detachment of the Retinal Pigment Epithelium
- •5.5 Geographic Atrophy of the RPE
- •Summary for the Clinician
- •References
- •6: Early AMD
- •Core Messages
- •6.1 Introduction
- •6.2 Drusen
- •6.2.3 Fluorescence Angiography and Optical Coherence Tomography
- •6.3 Focal Hypopigmentation and Hyperpigmentation of the Retinal Pigment Epithelium
- •6.4 Abnormal Choroidal Perfusion
- •Summary for the Clinician
- •References
- •Core Messages
- •7.1 Introduction
- •7.2.1 Decreased Visual Acuity
- •7.2.2 Visual Distortion
- •7.2.3 Visual Field Defects
- •7.2.4 Miscellaneous Symptoms
- •7.3 Signs of Choroidal Neovascularization
- •7.3.1 Hemorrhage
- •7.3.2 Macular Edema and Subretinal Fluid
- •7.3.3 Retinal Pigment Epithelial Detachment
- •7.3.4 Miscellaneous Signs
- •7.4 Common Testing Modalities to Diagnose Choroidal Neovascularization
- •7.4.1 Fluorescein Angiography
- •7.4.2 Indocyanine Green Angiography
- •7.4.4 Optical Coherence Tomography
- •Summary for the Clinician
- •References
- •8: Geographic Atrophy
- •Core Messages
- •8.1 Introduction
- •8.3 Histology and Pathogenesis of Geographic Atrophy
- •8.5 Spectral Domain Optical Coherence Tomography in Geographic Atrophy
- •8.7 Risk Factors
- •8.7.1 Genetic Factors
- •8.7.2 Systemic Risk Factors
- •8.7.3 Ocular Risk Factors
- •8.8 Development of CNV in Eyes with GA
- •8.9 Visual Function in GA Patients
- •8.9.1 Measurement of Visual Acuity
- •8.9.2 Contrast Sensitivity
- •8.9.3 Reading Speed
- •8.9.4 Fundus Perimetry
- •8.10 Perspectives for Therapeutic Interventions
- •8.10.2 Complement Inhibition
- •8.10.3 Neuroprotection
- •8.10.4 Alleviation of Oxidative Stress
- •8.10.5 Serotonin-1A-Agonist
- •8.10.6 Perspective
- •Summary for the Clinician
- •References
- •9: Fundus Imaging of AMD
- •Core Messages
- •9.1 Introduction
- •9.2 Color Photography
- •9.3 Monochromatic Photography
- •9.5 Optical Coherence Tomography
- •9.5.2 Coherence Length
- •9.5.3 Time Domain Optical Coherence Tomography
- •9.5.4 Frequency Domain Optical Coherence Tomography
- •9.5.5 Increasing Depth of Imaging
- •9.5.6 General Optical Coherence Tomographic Imaging Characteristics of the Macular Region
- •9.6 Fundus Angiography
- •9.6.1 Fluorescein Dye Characteristics
- •9.6.2 Indocyanine Green Dye Characteristics
- •9.6.3 Cameras Used in Fluorescence Angiography
- •9.6.4 Patient Consent and Instruction
- •9.6.5 Fluorescein Injection
- •9.6.6 Fluorescein Technique
- •9.6.7 Indocyanine Green Technique
- •9.7 Fluorescein Angiographic Interpretation
- •9.7.1 Filling Sequence
- •9.7.2 The Macula
- •9.8 Deviations from Normal Angiographic Appearance
- •9.10.1 Drusen
- •9.12 Neovascular AMD
- •9.13 Retinal Pigment Epithelial Detachments
- •9.14 Retinal Vascular Contribution to the Exudative Process
- •9.15 Follow-up
- •9.15.1 Thermal Laser
- •9.15.2 Photodynamic Therapy
- •9.15.3 Anti-VEGF Therapy
- •Summary for the Clinician
- •References
- •10: Optical Coherence Tomography
- •10.1 Introduction
- •Core Messages
- •10.4 OCT in Geographic Atrophy
- •10.5 OCT in Exudative AMD
- •Summary for Clinician
- •References
- •11: Microperimetry
- •Core Messages
- •11.1 Introduction
- •11.2.1 From Manual to Automatic Microperimetry
- •11.2.2 Automatic Microperimetry
- •11.2.3 Microperimetry: The Examination
- •11.2.4 Microperimetry: Test Evaluation
- •11.2.5 Other Microperimeter
- •11.3 Microperimetry in AMD
- •11.3.1 Early AMD
- •11.3.2 Geographic Atrophy
- •11.3.3 Neovascular AMD
- •11.3.4 Neovascular AMD: Treatment
- •Summary for the Clinician
- •References
- •Core Messages
- •12.1 Introduction
- •12.2 Antioxidants and Zinc
- •12.3 Beta-Carotene
- •12.4 Macular Xanthophylls
- •12.6 Vitamin E
- •12.7 Vitamin C
- •12.8 Zinc
- •12.10 AREDS2
- •Summary for the Clinician
- •References
- •Core Messages
- •13.1 Introduction
- •13.2 Basic Principles
- •13.2.1 Clinical Background
- •13.2.2 Laser Photocoagulation
- •13.2.3 Photodynamic Therapy
- •13.3 Treatment Procedures
- •13.3.1 Laser Photocoagulation
- •13.3.2 Photodynamic Therapy
- •13.4 Study Results
- •13.4.1 Laser Photocoagulation
- •13.4.1.1 Extrafoveal CNV
- •13.4.1.2 Subfoveal CNV
- •13.4.1.3 Meta-analysis
- •13.4.2 Photodynamic Therapy
- •13.4.2.1 Predominantly Classic
- •13.4.2.2 Occult with No Classic Neovascularization
- •13.4.2.3 Minimally Classic
- •13.5 Safety and Adverse Events
- •13.5.1 Laser Photocoagulation
- •13.5.2 Photodynamic Therapy
- •13.6 Variations
- •13.6.1 Laser Photocoagulation: Different Wavelengths
- •13.6.2 Photodynamic Therapy
- •13.6.3 Combination Treatments
- •13.7 Present Guidelines
- •13.7.1 Laser Photocoagulation
- •13.7.2 Photodynamic Therapy
- •13.8 Perspectives
- •Summary for the Clinician
- •References
- •Core Messages
- •14.1 Introduction
- •14.2 Vascular Endothelial Growth Factor (VEGF)
- •14.3 Targets Within the VEGF Pathway
- •14.3.1 Sequestration of Released VEGF
- •14.3.2 Inhibition of VEGF and VEGF Receptor Synthesis by Small Interfering RNA (siRNA)
- •14.3.3 Inhibition of the Intracellular Signal Cascade
- •14.3.4 Natural VEGF Inhibitors
- •14.4 New Methods of Drug Delivery
- •14.5 Combined Strategies
- •Summary for the Clinician
- •References
- •Core Messages
- •15.1 Introduction
- •15.1.1 Anti-VEGF Therapies for NV-AMD
- •15.2.1 How Should Neovascular AMD be Diagnosed?
- •15.2.4.1 Results with Continuous Monthly Treatment
- •15.2.4.2 How Should Treatment be Started?
- •15.2.4.3 What Flexible Approaches Are Reported?
- •Fixed Quarterly Injection Studies
- •Flexible Dosing Regimens: Two Approaches
- •Flexible Dosing Regimens: ‘As Needed’ Approach
- •Flexible Dosing Regimens: ‘Treat-and-Extend’ Approach
- •Summary for the Clinician
- •References
- •Core Messages
- •16.1 Introduction
- •16.3 Current Limitation of Therapy in the Treatment of Exudative AMD
- •16.4 Rationale for Combination Therapy in the Treatment of Exudative AMD
- •16.5 Clinical Data Examining Combination Therapy for Exudative AMD
- •16.5.3 Triple Therapy for Exudative AMD
- •16.5.4 Combination Therapy with Radiation
- •Summary for the Clinician
- •References
- •Core Messages
- •17.1 Introduction
- •17.2 Current Treatment Options for Dry AMD
- •17.3 Targeting the Cause of AMD
- •17.4 Preclinical and Phase I Drugs in Development for Dry AMD
- •17.4.1 Clinical Trial Endpoints in Dry AMD
- •Trimetazidine
- •17.4.2.2 Neuroprotection
- •Ciliary Neurotrophic Factor (CNTF/NT-501)
- •AL-8309B (Tandospirone)
- •Brimonidine Tartrate Intravitreal Implant
- •17.4.2.3 Visual Cycle Modulators
- •Fenretinide
- •17.4.2.4 Other
- •17.4.3 Drugs to Prevent Injury from Oxidative Stress and Micronutrient Depletion
- •17.4.4.1 Complement Inhibition at C3
- •17.4.4.2 Complement Inhibition at C5
- •Eculizumab
- •17.4.4.3 Complement Inhibition of Factor D
- •FCFD4514S
- •Iluvien
- •Glatiramer Acetate (Copaxone)
- •17.5 Summary
- •Summary for the Clinician
- •References
- •18: Surgical Therapy
- •Core Messages
- •18.1 Maculoplasty
- •18.2 Macular Translocation
- •18.3 Single Cell Suspensions
- •18.5 Indications for Surgery
- •18.5.1 Non-responder
- •18.5.2 Pigment Epithelium Rupture
- •18.5.3 Massive Submacular Bleeding
- •18.5.5 Macula Dystrophies
- •Summary for the Clinician
- •References
- •19: Reading with AMD
- •Core Messages
- •19.1 Introduction
- •19.2 Physiological Principles
- •19.3 Reading with a Central Scotoma
- •19.3.1.2 The Reading Visual Field Related to the Fundus (Fig. 19.4b)
- •19.3.1.3 The Reading Visual Field Related to the Text (Fig. 19.4c)
- •19.3.1.4 Eccentric Fixation Related to the Globe (Fig. 19.5)
- •19.3.3 Examination of Fixation Behaviour
- •19.3.4 Motor Aspects
- •19.4 Methods to Examine Reading Ability
- •19.5 Rehabilitation Approaches to Improve Reading Ability
- •Summary for the Clinician
- •References
- •20: Low Vision Aids in AMD
- •Core Messages
- •20.2 Effects of Visual Impairment in AMD
- •20.5 Optical Magnifying Visual Aids for Distance
- •20.5.1 Aids for Watching Television
- •20.8 Electronic Reading Instruments
- •20.9 Additional Aids
- •20.10 Noteworthy Details for the Provision of Low Vision Aids
- •20.11 Basic Information on Prescription
- •Summary for the Clinician
- •References
- •Index
List of Abbreviations
ABCA1 |
ATP-binding cassette, subfamily A |
AD |
Alzheimer’s disease |
AGE |
Advanced glycation end products |
ALA |
Alpha linoleic acid |
AMD |
Age-related macular degeneration |
APC |
Alternative pathway of complement |
APOE |
Apolipoprotein E |
ARM |
Age-related maculopathy |
ARMS2 |
Age-related maculopathy susceptibility 2 |
BCEA |
Bivariate contour ellipse calculated area |
BCVA |
Best corrected visual acuity |
BLD |
Basal laminar deposits |
BM |
Bruch’s membrane |
BMI |
Body mass index |
CC |
Choriocapillaris |
CCD |
Charge-coupled device |
CCTV |
Closed circuit television system |
CDCV |
Common disease – common variant |
CDRV |
Common disease – rare variant |
CEP |
Carboxyethylpyrrole |
CETP |
Cholesteryl ester transfer protein |
CFB |
Complement factor B |
CFH |
Complement factor H |
CFI |
Complement factor I |
CI |
Confidence interval |
CME |
Cystoid macular edema |
CNP |
Copy number polymorphism |
CNTF |
Ciliary neutrophic factor |
CNV |
Choroidal neovascularization |
CR1 |
Complement receptor 1 |
CRP |
C-reactive protein |
CRT |
Central retinal thickness |
CSC |
Central serous chorioretionopathy |
cSLO |
Confocal scanning laser ophthalmoscope |
DA |
Disc area |
DAF |
Decay-accelerating factor |
DHA |
Docosahexaenoic acid |
ECM |
Extracellular matrix |
xvii
xviii |
List of Abbreviations |
|
|
EDI-OCT |
Enhanced depth imaging spectral-domain optical coherence |
|
tomography |
EOG |
Electro-oculogram |
EPA |
Eicosapentanoic acid |
ESR |
Erythrocyte sedimentation rate |
F1 |
Factor 1 |
FAF |
Fundus autofluorescence |
FAZ |
Foveolar avascular zone |
FDA |
Food and Drug Administration |
FP |
Fundus perimetry |
FVPED |
Fibrovascular pigment epithelial detachment |
GA |
Geographic atrophy |
GCL |
Ganglion cell layer |
GWAS |
Genome-wide association study |
HDL-c |
High-density lipoprotein cholesterol |
HTRA1 |
High temperature requirement factor A1 |
ICG |
Indocyanine green |
ICAM |
Intracellular adhesion molecules |
IL6 |
Interleukin 6 |
IOP |
Intraocular pressure |
IPE |
Iris pigment epithelium |
IR |
Infrared |
IV |
Inverse variance |
IVB |
Intravitreal bevacizumab |
IVR |
Intravitreal ranibizumab |
IVTA |
Intravitreal triamcinolone |
LCPUFA |
Long-chain polyunsaturated fatty acids |
LDC |
Linkage disequilibrium |
LDL |
Low density lipoprotein |
LF |
Lipofuscin |
LIPC |
Lipase C |
LLUS |
Late leakage of undetermined source |
logMAR |
Logarithm of the minimum angle of resolution |
LPL |
Lipoprotein lipase |
LSC |
Long spaced collagen |
LVA |
Low vision aid |
MAC |
Membrane attack complex |
MAF |
Minor allele frequency |
MBL |
Mannose-binding lectin |
MCP |
Membrane cofactor protein |
MHC |
Major histocompatibility complex |
MMP |
Matrix metalloproteinase |
MPGN |
Membranoproliferative glomerulonephritis |
MPOD |
Macular pigment optical density |
NV-AMD |
Neovascular age-related macular degeneration |
OCT |
Optical coherence tomography |
OR |
Odds ratio |
ORCA |
Occult retinal choroidal anastomosis |
List of Abbreviations |
xix |
|
|
PAMP |
Pathogen-associated molecular pattern |
PAR |
Population attributable risk |
PATCH |
Pigment epithelium-choroid-translocation |
PCV |
Polypoid choroidal vasculopathy |
PD |
Pupillary distance |
PDGF |
Platelet-derived growth factor |
PDT |
Photodynamic therapy |
PE |
Pigment epithelium |
PED |
Pigment epithelium detachment |
PEDF |
Pigment epithelium derived factor |
PFCL |
Perfluorocarbon liquid |
PHP |
Preferential hyperacuity perimeter |
PLGF |
Placental growth factor |
PLEKHA1 |
Pleckstrin homology domain-containing |
|
protein family A member 1 |
PNH |
Paroxysmal nocturnal hemoglobinuria |
PON1 |
Paraoxonase 1 gene |
POS |
Photoreceptor outer segment |
PRL |
Preferred retinal locus |
PRN |
Pro re nata |
PRR |
Pattern recognition receptor |
PSDDS |
Posterior segment drug delivery system |
PVR |
Proliferative vitreoretinopathy |
RAP |
Retinal angiomatous proliferation |
RBP |
Retinol-binding protein |
RCA |
Regulators of complement activation |
RCOphth |
Royal College of Ophthalmologists |
RCT |
Randomized controlled trial |
RF |
Reduced fluence rate |
RNFL |
Retinal nerve fiber layer |
ROS |
Reactive oxygen species |
RPE |
Retinal pigment epithelium |
RR |
Relative risk |
RTK |
Receptor tyrosine kinases |
rTPA |
Recombinant tissue plasminogen activator |
RVAC |
Retinal vascular anomalous complexes |
SD-OCT |
Spectral domain optical coherence tomography |
SF |
Standard fluence rate |
SLD |
Superluminescent diodes |
SLO |
Scanning laser ophthalmoscope |
SNP |
Single nucleotide polymorphism |
SOD2 |
Superoxide Dismutase 2 |
Sr-90 |
Strontium-90 |
SS-OCT |
Swept source optical coherence tomography |
TD-OCT |
Time domain optical coherence tomography |
TIMP |
Tissue inhibitor of metalloproteinases |
TLR |
Toll-like receptor |
TP-H |
TEMPOL-H |
xx
UTR |
Untranslated region |
VA |
Visual acuity |
VCM |
Visual cycle modulators |
VEGF |
Vascular endothelial growth factor |
VPDT |
Verteporfin photodynamic therapy |
WWC |
White cell count |
List of Abbreviations
Part I
Pathophysiology
Chapter 1 Epidemiology of AMD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
3 |
|
Chapter 2 |
Genetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. |
31 |
Chapter 3 |
Ageing of the Retina and Retinal Pigment Epithelium . . . . . . |
45 |
Chapter 4 |
The Complement System in AMD. . . . . . . . . . . . . . . . . . . . . . . |
65 |
Chapter 5 |
Histopathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
77 |
