Age-related macular degeneration (AMD) is by no means a newly discovered disease, but the ability to treat it effectively is something we as clinicians did not achieve until recently. The first reports of the symptoms and characteristics of AMD were published by Franciscus Donders in 1854, and the first case reports on macular degeneration were published in 1904.1 Back then, physicians were just gaining an understanding of the disease, and they were not able to do much for patients who had it. Fortunately, we now have access to effective pharmaceutical treatments, and are therefore able to help more of our patients who have AMD preserve visual acuity. In fact, because of the discovery and advancements in anti-VEGF agents, we can now expect to restore vision in most patients with AMD.

Of course, the fact that our profession has reached this point does not mean we can kick back with our feet up. Quite the contrary: Now is the time to think beyond the anti-VEGF paradigm. Why? Because the future is filled with possibility—there may be something better than anti-VEGF therapy out there, but the only way to know for sure is to press on. Besides, the more treatment options there are available, the better we as physicians will be able to individualize therapy and to improve outcomes.

Thanks to close collaboration between industry and physicians, AMD is becoming less and less daunting. New developments in treating this sight-robbing disease continue to offer us a more comprehensive bank of information that we can draw from to guide patients’ education, create a successful clinical follow-up plan, and exceed patients’ expectations.

This issue focuses on AMD treatments and innovations, and we have a great lineup of articles for you on the topic, some of which involve anti-VEGF therapy and some of which reach beyond. Scott W. Cousins, MD, explores the role of mitochondrial dysfunction in dry AMD and how the site of intracellular metabolism may be a relevant drug target in this form of the disease. Kent Small, MD, and colleagues examine the role of photodynamic therapy when used in combination with an anti-VEGF agent to treat neovascular AMD. SriniVas R. Sadda, MD, and colleagues write about optical coherence tomography angiography and how it may affect the way we manage patients who have both neovascular and non-neovascular AMD.

We hope you will agree that the articles in this issue are important for looking beyond the anti-VEGF treatment paradigm, potentially to a time in history when we will be able to do even more to help our patients with AMD save and restore their vision. n

1. Bright Focus Foundation. http://www.brightfocus.org/questions-answers/in-what-year-was-macular.html. Accessed May 18, 2015.

Robert L. Avery, MD,
Associate Medical Editor

Allen C. Ho, MD,
Chief Medical Editor