A H C Koh1, C L Ang. 1. Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751. adrian_koh@snec.com.sg
Abstract
INTRODUCTION: Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in the developed western world, accounting for approximately 50% of all cases of registered blindness. The rising prevalence of this disease in Asia seems to parallel the same trend in the developed world. Because of the socio-economic impact of this disorder, much attention has been paid to elucidating the underlying pathogenic mechanisms, as well as seeking alternative forms of treatment. This review discusses the latest advances in AMD diagnosis, treatment and prophylaxis. METHODS: Medline search with emphasis on randomised controlled clinical trials and large case-control series. Only articles cited on the Index Medicus were included in this review. RESULTS: Recent advances in the diagnosis and treatment of AMD include conventional argon laser photocoagulation, photodynamic therapy (PDT), radiation therapy, surgical options and gene therapy. CONCLUSIONS: There have been numerous advances in the management of AMD and exciting new research applications have emerged. The introduction of exciting new modalities, such as PDT, has revolutionised the approach to treating CNVM and their effects on central vision. However, there has been no breakthrough in achieving satisfactory outcomes with the available techniques for treating occult neovascular lesions. As results of large prospective randomised clinical trials evaluating new treatment alternatives become available, a treatment algorithm for neovascular AMD will emerge that best minimises visual loss and may even result in visual improvement.
INTRODUCTION: Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in the developed western world, accounting for approximately 50% of all cases of registered blindness. The rising prevalence of this disease in Asia seems to parallel the same trend in the developed world. Because of the socio-economic impact of this disorder, much attention has been paid to elucidating the underlying pathogenic mechanisms, as well as seeking alternative forms of treatment. This review discusses the latest advances in AMD diagnosis, treatment and prophylaxis. METHODS: Medline search with emphasis on randomised controlled clinical trials and large case-control series. Only articles cited on the Index Medicus were included in this review. RESULTS: Recent advances in the diagnosis and treatment of AMD include conventional argon laser photocoagulation, photodynamic therapy (PDT), radiation therapy, surgical options and gene therapy. CONCLUSIONS: There have been numerous advances in the management of AMD and exciting new research applications have emerged. The introduction of exciting new modalities, such as PDT, has revolutionised the approach to treating CNVM and their effects on central vision. However, there has been no breakthrough in achieving satisfactory outcomes with the available techniques for treating occult neovascular lesions. As results of large prospective randomised clinical trials evaluating new treatment alternatives become available, a treatment algorithm for neovascular AMD will emerge that best minimises visual loss and may even result in visual improvement.