Editors Frank G.Holz Richard F. Spaide. Medical Retina. With 91 Figures, Mostly in Colour and13tables. Springer

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1 Editors Frank G.Holz Richard F. Spaide Medical Retina With 91 Figures, Mostly in Colour and13tables Springer

ääm mm.m iiiii HHHHHMmi Chapter1 Microperimetry in Macular Disease Klaus Rohrschneider 1.1 Introduction 1 1.2 Instruments 2 1.2.1 Scanning Laser OphthaImoscope 2 1.2.1.1 Fundus Perimetry (Microperimetry) 3 1.

2 ääm mm.m iiiii HHHHHMmi Chapter1 Microperimetry in Macular Disease Klaus Rohrschneider 1.1 Introduction Instruments Scanning Laser OphthaImoscope Fundus Perimetry (Microperimetry) Micro Perimeter StaticThreshold Fundus Perimetry Kinetic Fundus Perimetry Comparison Between SLO Perimetry and MP Accuracy of Fundus Perimetry StaticThreshold Perimetry Kinetic Perimetry Fundus-related Perimetry Versus Cupola Perimetry Clinical Implementation Macular Holes Age-related Macular Degeneration Geographie Atrophy ofthe RPE Choroidal Neovascularization in AMD Diabetic Retinopathy Central Serous Chorioretinopathy Stargardt's Disease Vitelliform Macular Dystrophy(Best'sDisease) Conclusion 16 Chapter 2 New Developments in cslo Fundus Imaging Giovanni Staurenghi, Grazia Levi, Silvia Pedenovi, Chiara Veronese 2.1 Introduction Near Infrared Imaging Introduction The Effect of Wavelength on Imaging in the Human Fundus Comparison of Light Tissue Interactions for Visible and Near Infrared Wavelengths UsingSLO Mode of Imaging Contrast ofthe Fundus Fundus Features Imaging of Pathological Features in Direct and Indirect Mode Blue Autofluorescence Imaging Autofluorescence and the Eye Fluorescence ofthe Retinal Pigment Epithelium How to Evaluate RPE Autofluorescence Fundus Autofluorescence Changes in Early AMD Fundus Autofluorescence Changes in Choroidal Neovascularization in AMD Fundus Autofluorescence Changes in Geographie Atrophy in AMD Fundus Autofluorescence in Acute and Chronic Recurrent Central Serous Chorioretinopathy 27

2.3.6 2.3.7 2.4 2.4.1 2.4.2 2.4.2.1 2.4.2.2 2.4.2.3 2.4.3 2.4.4 Fundus Autofluorescence in Stargardt's Macular Dystrophy-Fundus Flavimaculatus.

3 Fundus Autofluorescence in Stargardt's Macular Dystrophy-Fundus Flavimaculatus.. 27 Fundus Autofluorescence in Patients with Macular Holes.. 28 Wide-Field Contact Lens System.. 28 Introduction.. 28 Materials and Methods Structure ofa Wide-Field Contact Lens System.. 29 Limit and Advantage of a Wide-Field Contact Lens System.. 29 Technique for Performing the Examination.. 29 OtherTechniques of Execution of Wide-field Fluorescein Angiograms Clinical Application.. 31 Chapter 3 Genetics of Age-Related Macular Degeneration: Update Hendrik P.N. Scholl, Monika Fleckenstein, Peter Charbel Issa, Claudia Keilhauer, Frank G. Holz, Bernhard H.F. Weber 3.1 Introduction: Genetic Influence on AMD Analysis of Candidate Genes for AMD Linkage and Association StudiesinAMD Complement Factor H Gene LOC Factor B Gene-Gene and Gene-Environment Interaction in AMD Conclusions 46 Chapter 4 Anti-VEGF Treatment for Age- Related Macular Degeneration Todd R. Klesert, Jennifer I. Lim 4.1 Basic Science Historical Perspective 53 VEGFIsoforms 54 VEGF Expression 54 VEGF Receptors 54 VEGFActivity 55 Current Anti-VEGF Therapies 55 Aptamers: Pegaptanib Sodium (Macugen) 55 Monoclonal Antibodies: Ranibizumab (Lucentis) 56 Monoclonal Antibodies: Bevacizumab (Avastin) 58 Anti-VEGF Therapy: Practical Considerations 60 Intravitreal Injection Technique 60 Safety Considerations 60 Bevacizumab (Avastin) Preparation: Compounding Pharmacies 61 Future Anti-VEGF Therapies 61 VEGFTrap 61 Small Interfering RNAs 62 ReceptorTyrosine Kinase Inhibitors 63 Conclusion 64 Chapter 5 Intravitreal Injections: Techniques and Sequelae Heinrich Heimann 5.1 Introduction Complications of Intravitreal Injections Methodology Perioperative Complications Conjunctival Hemorrhage Conjunctival Scarring Pain Punctate Keratitis and Corneal Edema Vitreous Reflux Traumatic Cataract Cataract Progression Retinal Perforation Vitreous Floaters Vitreous Hemorrhage Retinal Toxicity Intraocular Inflammation 74

5.2.2.13 Uveitis and Pseudoendophthalmitis 75 5.2.2.14 Endophthalmitis 76 5.2.2.15 Retinal Artery and Vein Occlusion 78 5.2.2.16 Retinal Detachment 78 5.2.2.17 Acute Rise in Intraocular Pressure 79 5.

4 Uveitis and Pseudoendophthalmitis Endophthalmitis Retinal Artery and Vein Occlusion Retinal Detachment Acute Rise in Intraocular Pressure Ocular Hypertension and Glaucoma SurgicalTechnique for Intravitreal Injection Guidelines and Preferred Practice Survey Preoperative Assessment and Preparation Concomitant Eye Diseases Preoperative Assessment Preoperative Medication Location Preparation ofthe Eye and OcularAdnexa PreparationoftheSurgeon Preparation ofthe Drug Injection Syringe and Needle Position ofthe Injection EntryPath Advancementof Needle and Injection Postoperative Assessment Assessment Immediately Following the Injection Topical Therapy Follow-up Examinations 85 Chapter 6 Combination Therapies for Choroidal Neovascularization Richard F. Spaide 6.1 Introduction Angiogenesis Development ofcnv Cancer and Angiogenesis Normalization of Tumor Vasculature Two-Component Model of CNV Two-Component Model and Therapy Are There Cytokines to Block OtherThanVEGF? Combination Therapies Anti-VEGF Biologics and PhotodynamicTherapy Anecortave Acetate and Photodynamic Therapy Intravitreal Triamcinolone and Photodynamic Therapy Triamcinolone and Anti- VEGFTherapy Triamcinolone and Anecortave Acetate Conclusion 99 Chapter 7 Nutritional Supplementation in Agerelated Macular Degeneration Hanna R. Coleman, Emily Y. Chew 7.1 Introduction Risk Factors Age-Related Eye Disease Study Lutein/Zeaxanthin Zinc Vitamin E Dietary Fat Intake Age-Related Eye Disease Study Conclusion 708 Chapter 8 New Perspectives in Geographie Atrophy Associated with AMD Steffen Schmitz-Valckenberg, Monika Fleckenstein, Hendrik P.N. Scholl, Frank G. Holz 8.1 Introduction Basics Development and Spread of Atrophy Fundus Autofluorescence Imaging in Geographie Atrophy Quantification of Atrophy Progression 7 77

8.4 Risk Factors 7 78 8.4.1 Genetic Factors 7 78 8.4.2 Systemic Risk Factors 118 8.4.3 Ocular Risk Factors 119 8.5 Development of CNV in Eyes withga 122 8.6 Visual Function in GA Patients 123 8.6.1 Measurement of Visual Acuity 123 8.

5 8.4 Risk Factors Genetic Factors Systemic Risk Factors Ocular Risk Factors Development of CNV in Eyes withga Visual Function in GA Patients Measurement of Visual Acuity Contrast Sensitivity Reading Speed Fundus Perimetry 724 Chapter 9 Diabetic Macular Edema: Current Treatments Florian K.P. Sutter, Mark C. Gillies, Horst Heibig 9.1 Introduction Epidemiology Pathophysiology Diabetic Macular Edema and Laboratory Science Qualityofüfe Diagnosis and Screening Types of Diabetic Macular Clinically Significant Macular Focal Diabetic Macular Diffuse Diabetic Macular Cystoid Macular Ischemic Macular Edema OCT Patterns of Diabetic Macular 9.8 Treatment Systemic Treatment Glycemic Control Blood Pressure Control Reducing Levels of Blood Lipids Treatment of Renal Dysfunction and Anemia Smoking Systemic Pharmacotherapy PKC-ß Inhibitors Aldose Reductase and AGE Inhibitors 736 Antioxidants 736 ATeam Approach to the Prevention of Loss of Vision in People with Diabetes 737 Local Ophthalmie Treatment 738 Focal Macular Laser 138 Grid Macular Laser 738 Recent Trends in Macular Laser Therapy 738 Micropulsed, Sub-threshold "Selective" Laser Therapy Vitrectomy 739 Intravitreal Steroids 739 Periocular Steroids 740 Intravitreal Anti-VEGF Antibodies 740 Cataract Surgery 747 Current Clinical Practice/ Recommendations 747 Chapter10 Treatment of Retinal Vein Occiusions Rajeev S. Ramchandran, R. Keith Shuler, Sharon Fekrat 10.1 Introduction Pathophysiology Branch and Central Vein Occlusion Studies Background Branch Vein Occlusion Study Central Vein Occlusion Study Systemic Pharmacologic Treatments Targeting Macular Edema Intravitreal Pharmacotherapy Background Intravitreal Triamcinolone: BRVO Intravitreal Triamcinolone: CRVO Fluocinolone Acetonide Intravitreal Implant 753

10.6.5 Standard of Care vs. Corticosteroid for Retinal Vein Occlusion Study 754 10.6.6 I ntravitrea I Anti-VEG F Therapy 755 10.7 SurgicalTreatments 756 10.7.1 BRVO 756 10.7.2

6 Standard of Care vs. Corticosteroid for Retinal Vein Occlusion Study I ntravitrea I Anti-VEG F Therapy SurgicalTreatments BRVO CRVO Laser-Induced Venous Chorioretinal Anastomosis RecombinantTissue Plasminogen Activator RadialOpticNeurotomy Intravitreal Triamcinolone: As AdjunctiveTherapy Prevention Systemic Factor Control Conclusion 758 Chapter11 New Perspectives in Stargardt's Disease Noemi Lois 11.1 Introduction EpidemiologyandClinical Findings Imaging Studies Fluorescein Angiography Indocyanine Green Angiography Fundus Autofluorescence Optical Coherence Tomography Electrophysiology and Psychophysics Histopathology Differential Diagnosis Genetics and Molecular Biology Animal Models of STGD- FFM Current and Future Treatments 777 Chapter12 Idiopathic Macular Teiangiectasia Peter Charbel Issa, Hendrik P.N. Scholl, Hans-Martin Helb, Frank G. Holz 12.1 Introduction Type 1 Idiopathic Macular Teiangiectasia Epidemiology Diagnostic Approach and Clinical Findings Functional Implications Pathophysiological Considerations Therapy Type 2 Idiopathic Macular Teiangiectasia Epidemiology Diagnostic Approach and Clinical Findings Functional Implications Associated Diseases Pathophysiological Considerations TherapeuticApproaches Type 3: Idiopathic Macular Teiangiectasia Perspectives 794 Chapter 13 Artificial Vision Peter Walter 13.1 Introduction Current Concepts for Restoring Vision Using Electrical Stimulation Interfacing the Neurons Epiretinal Stimulation Subretinal Approach Transchoroidal, Transscleral, and Suprachoroidal Stimulation Optic Nerve Approach Cortical Prosthesis Pixel Vision and Filters Outlook Conclusion 206 Subject Index 277

F. G. Holz R. F. Spaide Editors

Essentials in Ophthalmology Medical Retina F. G. Holz R. F. Spaide Editors Essentials in Ophthalmology G. K. Krieglstein R. N. Weinreb Series Editors Glaucoma Cataract and Refractive Surgery Uveitis and