Recent Developments in the Treatment of Wet Age-related Macular Degeneration

Age-related macular degeneration(AMD)is the most common cause of irreversible blindness and visual impairment in individuals over the age of 50 years in western societies.More than 25 million people currently suffer from this illness in the world,with an additional 500000 every year,approximately.It is a multifactorial ocular disease that affects the maculae due to a late-onset progressive neurodegeneration and dysfunction of photoreceptors and retinal pigment epithelium(RPE).There are many subtypes of AMD but basically two broad forms:the nonneovascular(dry,nonexudative)and neovascular(wet,exudative).Exudative AMD is the less common form(about 15%)but tends to progress more rapidly.At the moment,wet AMD is treated primarily on the basis of anti-vascular endothelial growth factor(VEGF)agents,which have led to massive improvement in the prognosis of the disease since they were first introduced.This article focuses on the latest treatment approaches to neovascular AMD.An extensive literature review was performed in order to illustrate the effectiveness of current and future anti-VEGF agents as well as the landmark clinical studies that have been carried out to establish these drugs as a gold standard in the therapy of wet AMD.

Angiographic characteristics of central serous chorioretinopathy in an Egyptian population

· AIM: To describe and analyze the demographic characteristics and to determine the angiographic features of acute central serous chorioretinopathy(CSCR) in an Egyptian population. ·METHODS: A series of consecutive patients presenting with acute idiopathic CSCR to Mansoura Ophthalmology Center Mansoura University who underwent fluorescein angiography (FA) within a 3 -year -period (between January 1, 2007 and December 31, 2009) was retrospectively studied. Patient demographics and angiographic features were studied. Results were compared to those of other Western and Asian populations. ·RESULTS: Fluorescein angiograms of 86 patients were analyzed. 91% were males. The age range of patients was 24 -49 years, with a mean age of (38±6) years. The right eye was the presenting eye in 47% of patients. Eighty seven percent of eyes showed delayed choroidal filling. Thirty -five percent of patients had more than one point of leakage. The macula was the most common site of fluorescein leakage seen in 79% of patients. Peripheral leakage was seen in 14% of patients while peripapillary leakage was seen in 12% of patients. The inkblot leakage pattern was found in 53% of patients. The presenting eye had RPE atrophic changes in 84% of cases. The other eye was assessed in 44 patients (51%). Fifty-five percent of them had signs of RPE atrophic changes. ·CONCLUSION: In the Egyptian population, CSCR is seen at younger age with higher male -to -female ratio and more frequent smokestack leaks than other populations. Despite younger age group, this series of patient showed higher frequency of bilateral and multifocal disease compared to other studies. Roles of psychological stress and choroidal ischemia in pathogenesis of CSCR need further evaluation. ·