From the Editor:
We have come so far but yet we know so little. Our understanding of age-related macular degeneration (AMD) has evolved over the past 40 years from a condition which was almost guaranteed to cause blindness (although we as ophthalmologists used to assure our patients that “black” blindness would never occur) to a disease for which some degree of control is now possible. A cure is not yet in sight. We have gone from thermal lasers to photodynamic therapy. We have gone from photography to fluorescein angiography and indocyanine green angiography to multimodal imaging of the disease.
Some of the articles provided address AMD, its diagnosis and its treatment.
Primary care physicians, internists, and patients alike all asked the question of the relationship between cardiovascular disease and age-related macular degeneration. Yang, Wang, and others take a look at whether we any closer to finding that answer.
Some suggest that there is a relationship between age-related macular degeneration and diabetic retinopathy, see article by Hahn, Acquah, and others. Computers and Medicare databases now allow us to ask those questions and seek answers.
We should not forget the possible relationship of the vitreous and its proximity and physical attachment to the retina as discussed in the article by Jackson, Nicod, and others. In fact what is the effect of vitreous traction on age-related macular degeneration?
Outer retinal tabulation has now been recognized as an important feature of macular degeneration and its clinical correlation has now been well demonstrated.
The more advanced we become the more complicated our evaluation of patients has become. Multimodal imaging and multimodal vision testing in age-related macular degeneration has now become critically important and is discussed below in the article by Schaal, Freund, and coauthors.
While the MPS stressed the importance of differentiating occult from classic choroidal neovascularization, modern technology has led many physicians to simply look at an OCT to determine if treatment is necessary. Perhaps it is time for us to use multimodal imaging such as fluorescein angiography, ICG angiography, and optical coherence tomography together to help us understand and differentiate type I choroidal neovascularization that occurs secondary to chronic central serous choroidopathy from neovasculariaztion secondary to age-related macular degeneration. Differentiating the cause for the choroidal neovascularization might lead us to a different treatment paradigm than treating all choroidal neovascularization the same way (see article by Fung, Yannuzzi, and Freund).
All articles presented here are freely available for download.