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Age-Related Macular Degeneration

  • Victoria NorthEmail author
  • Srilaxmi Bearelly
Chapter

Abstract

Age-related macular degeneration (AMD) is one of the leading causes of blindness in the developed world. AMD can be non-neovascular or neovascular, and either type can progress to irreversible central vision loss. In the primary care setting, emphasis is on early detection of disease and prevention of progression to advanced disease when possible. This requires close follow-up, education, and lifestyle modification. Supplementation with antioxidants and zinc may be useful for patients with moderate disease. For patients with neovascular AMD, treatment with intravitreal injection of anti-VEGF molecules such as ranibizumab can slow disease progression and may even improve vision from baseline presentation. Finally, there are many promising areas of ongoing research with the potential to influence treatment and prognosis. These include intraocular implants that may provide sustained delivery of biologics, complement factor inhibitors, retinoid inhibitors, RPE or stem cell transplantation, and many more.

Keywords

Age-related macular degeneration Neovascular age-related macular degeneration Non-neovascular age-related macular degeneration Photodynamic therapy for age-related macular degeneration Age-related macular degeneration and micronutrients deficiency Amsler grid Pharmacotherapy for neovascular age-related macular degeneration 

Suggested Reading

  1. Age-Related Eye Disease Study Research Group. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS report no. 8. Arch Ophthalmol. 2001;119(10):1417–36.PubMedCentralCrossRefGoogle Scholar
  2. Age-Related Eye Disease Study Research Group. Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial. JAMA. 2013;309(19):2005–15.CrossRefGoogle Scholar
  3. Chakravarthy U, Adamis AP, Cunningham ET, et al. Year 2 efficacy results of 2 randomized controlled clinical trials of pegaptanib for neovascular age-related macular degeneration. Ophthalmology. 2006;113(9):1508.e1–25.Google Scholar
  4. Chew EY, Clemons TE, Agrón E, et al. Ten-year follow-up of age-related macular degeneration in the age-related eye disease study: AREDS report no. 36. JAMA Ophthalmol. 2014a;132(3):272–7.PubMedCrossRefGoogle Scholar
  5. Chew EY, Clemons TE, Sangiovanni JP, et al. Secondary analyses of the effects of lutein/zeaxanthin on age-related macular degeneration progression: AREDS2 report No. 3. JAMA Ophthalmol. 2014b;132(2):142–9.PubMedPubMedCentralCrossRefGoogle Scholar
  6. Congdon N, O’Colmain B, Klaver CC, et al. Causes and prevalence of visual impairment among adults in the United States. Arch Ophthalmol. 2004;122(4):477–85.PubMedCrossRefGoogle Scholar
  7. Finger RP, Chong E, McGuinness MB, et al. Reticular pseudodrusen and their association with age-related macular degeneration: the Melbourne collaborative cohort study. Ophthalmology. 2016;123(3):599–608.PubMedCrossRefGoogle Scholar
  8. Friedman DS, O’Colmain BJ, Muñoz B, et al. Prevalence of age-related macular degeneration in the United States. Arch Ophthalmol. 2004;122(4):564–72.PubMedCrossRefGoogle Scholar
  9. Holz FG, Strauss EC, Schmitz-Valckenberg S, van Lookeren Campagne M. Geographic atrophy: clinical features and potential therapeutic approaches. Ophthalmology. 2014;121(5):1079–91.PubMedCrossRefGoogle Scholar
  10. Kaiser PK, Brown DM, Zhang K, et al. Ranibizumab for predominantly classic neovascular age-related macular degeneration: subgroup analysis of first-year ANCHOR results. Am J Ophthalmol. 2007;144(6):850–7.PubMedCrossRefGoogle Scholar
  11. Rosenfeld PJ, Brown DM, Heier JS, et al. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006;355(14):1419–31.PubMedCrossRefGoogle Scholar
  12. Tan JS, Mitchell P, Kifley A, Flood V, Smith W, Wang JJ. Smoking and the long-term incidence of age-related macular degeneration: the Blue Mountains Eye Study. Arch Ophthalmol. 2007;125(8):1089–95.PubMedCrossRefGoogle Scholar
  13. Virgili G, Bini A. Laser photocoagulation for neovascular age-related macular degeneration. Cochrane Database Syst Rev. 2007;3:CD004763.Google Scholar
  14. Wormald R, Evans J, Smeeth L, Henshaw K. Photodynamic therapy for neovascular age-related macular degeneration. Cochrane Database Syst Rev. 2007;3:CD002030.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of OphthalmologyHarvard Medical SchoolBostonUSA
  2. 2.Columbia University Irving Medical CenterNew YorkUSA
  3. 3.Department of Ophthalmology, Edward S. Harkness Eye InstituteColumbia University Vagelos College of Physicians and SurgeonsNew YorkUSA

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