Contents

### **Preface XI**


Chapter 5 **Anti VEGF Agents for Age Related Macular Degeneration 163** Shani Golan, Michaella Goldstein and Anat Loewenstein

Preface

exudative forms of age-related macular degeneration.

book as I have had writing and editing it.

Management of the patient affected by age-related macular degeneration (AMD) represents a para‐ digm challenge. Research has yielded major discoveries about the etiology, pathophysiology, and treatment of AMD over the last decade, although more steps are needed to continue to improve our know-how. The purpose of *"Age-related Macular Degeneration - Etiology, Diagnosis and Manage‐ ment - A Glance at the Future"* is to provide up-to-date information of the pathophysiology, diagno‐ sis, management, and treatment of age-related macular degeneration. In this volume I have attempted to collect a significant amount of new information from retinal experts to first summa‐ rize the established information and then to present the most novel developments in their respec‐ tive fields. The first section of this book includes the pathophysiology and epidemiology, of agerelated macular degeneration. Oxidative damage to the RPE, extracellular matrix turnover, inflammation, and angiogenesis appear to be key cellular processes that play a central role in the pathogenesis of AMD. Some chapters will focus on the pathobiology of early stage AMD and its evolution to the later form also exploring the role of injury at the RPE in the onset and develop‐ ment of the disease. The second section focuses on the clinical features and diagnosis of age-related macular degeneration. The clinical findings seen in the nonexudative and exudative forms are dis‐ cussed. The section on imaging includes a chapter on new OCT technology including: Swept Source OCT (SS-OCT), Enhanced Depth Imaging OCT (EDI-OCT), and adaptive optics. A variety of emerging OCT technologies are poised to expand significantly the scope of OCT imaging and to enhance significantly our approach to the diagnosis and management of patients with retinal dis‐ ease. An in-depth understanding of these technologies and their potential advantages and disad‐ vantages will aid retinal specialists in utilizing these new methods optimally. The next and last section reports information on current and experimental forms of treatment for non-exudative and

The advent of intravitreal anti-VEGF therapy (targeting all isoforms) dramatically altered the standard of care and treatment paradigms for patients with NVAMD. However, In spite of this significant step forward in the treatment of NVAMD, significant challenges remain. The presenta‐ tion of the treatment options includes a discussion of the mechanism of action, the clinical treat‐ ment technique, the targeted patient population, as well as the expected outcomes of each treatment. No single manageable volume can analyze all of the existing knowledge concerning a disease such as age-related macular degeneration. Special attention has been paid to making the text easily readable. My sincere hope is that readers will find as much pleasure reading this text‐

**Dr. Giuseppe Lo Giudice**

*To my father*

San Paolo Ophthalimc Center, San Antonio Hospital, Italy
