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Age-related macular degeneration (AMD) is the leading cause of significant visual acuity loss in people over the age of 50 in developed countries. Almost 80% of the people diagnosed with AMD will have the non-neovascular (dry) or atrophic subtypes. Here is the clinical information patients need to understand this disease.

There is subset of patients with resistant or persistent DME that forms the impetus for new treatment strategies, including next-generation anti-VEGF-A and new classes of drugs. Pravin U. Dugel, MD, outlines a list of potential treatment candidates that may lead that paradigm shift.

Two of the top 10 “most-talked-about” articles in JAMA Ophthalmology are about age-related macular degeneration (AMD). One of the current top 5 “most-read” articles in the American Journal of Ophthalmology is also about AMD. Here are a brief synopsis of those three papers.

The American Academy of Ophthalmology’s Preferred Practice Pattern on Age-Related Macular Degeneration “are based on the best available scientific data as interpreted by panels of knowledgeable health professionals.” These patterns offer solid clinical guidelines for treating and counseling AMD patients.

In patients with age-related macular degeneration managed by a treat-and-extend regimen, the visual acuity generally was maintained; lesion reactivation occurred frequently at about eight weeks; and longer induction phases between treatments was associated with worse outcomes.

Voretigene neparvovec-rzyl (Luxturna, Spark Therapeutics) was approved in December 2017 for the treatment of patients with confirmed biallelic RPE65 mutation-associated retinal dystrophy. Clinical trial results and patient selection issues for this gene therapy are discussed.

A well-known dilemma surrounding AMD is that there lacks a universally accepted treatment regimen with anti-VEGF injections. The balance between optimal visual outcomes and treatment burden has led some specialists to embrace the treat-and-extend regimen over monthly treatments.

Since February is designated Age-Related Macular Degeneration Awareness month. For healthcare providers, there are numerous resources available to help promote awareness to patients and to encourage patients to continue (or start) annual visual exams.

Sixteen fellows and residents show just why research in retina is on the cutting edge

Results of the prospective TREX-DME study provide an evidence base for using a treat-and-extend protocol for administering anti-VEGF injections for eyes with diabetic macular edema.

Suprachoroidal triamcinolone acetonide (CLS-TA, Clearside Biomedical) injection resulted in visual and anatomic improvements in eyes with diabetic macular edema, particularly in those that were treatment-naïve. Multiple injections of the investigational treatment were well-tolerated and associated with a low incidence of IOP elevation.

Real-world data on a fluocinolone acetonide intravitreal implant show sustained benefits of switching to the treatment in pseudophakic eyes that are insufficiently responsive to other therapies.

OCT has many benefits, yet falls short of reliably diagnosing and managing retinopathies and glaucoma. ERG remains the stalwart method for this application and this article highlights how technological advancements have enabled its introduction to the clinic.

A dark adaptometer (AdaptDx; MacuLogix Inc) can aid in the diagnosis of early-stage, or subclinical, age-related macular degeneration before visual loss occurs and even before structural changes are observed, and adds to the information obtained from retina cameras and OCT imaging.

Quantitative assessment of retinovascular features on ultra-widefield angiography images showed significant improvements in leakage and ischemia following treatment with aflibercept in patients with diabetic macular edema and retinal vein occlusion.

Computerized testing of contrast sensitivity function using the Sentio Platform (Adaptive Sensory Technology) may better quantify the visual limitations of patients than traditional letter acuity after retinal detachment repair.