Predictive, preventive and personalised medicine for age-related macular degeneration

Abstract

Age-related macular degeneration (AMD) is an ophthalmologic disease which usually affects older adults and represents the leading cause of legal blindness in Europe and the United States of America. The pathogenesis of AMD is complex and, nowadays, the treatments are targeting more the late form of the disease. Age and genetic make-up are the most important risk factors identified to date. There are undoubtedly environmental and other risk factors involved and the adverse effect of smoking is well established. New treatments for AMD have emerged with improved prognostic outcome. This remarkable advances in our understanding of the genetic and biological foundations of this disease were derived from a recent convergence of scientific and clinical data. In the near future we will have several therapeutic options for treatment of AMD at different stages and therefore personalising more and more the treatment.

Fig. 1

82-year old patient with advanced AMD and decreased visual acuity to hand motions in the right eye. The central area of the retina, called the macula, is affected by a large scar tissue

Fig. 2

Same eye and patient as in Fig. 1. Optical coherence tomography (OCT) showing the atrophy of the retina and the subretinal scar tissue

Fig. 3

Same eye and patient as in Fig. 1. Fluorescent angiography (FLA) late phase reveals the large area of the involved tissue in the macula