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Vision
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Age-Related Macular Degeneration
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Age-Related Macular Degeneration

A special issue of Vision (ISSN 2411-5150).

Deadline for manuscript submissions: closed (30 June 2018) | Viewed by 37661

Special Issue Editors

Prof. Dr. R. Theodore Smith

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Guest Editor
Department of Ophthalmology, NYU Langone Medical Center, New York, NY 10016, USA
Interests: macular degeneration; retinal drusen; retinal pigment epithelium; geographic atrophy; retina
Prof. Dr. Victor Chong

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Guest Editor
Division of Ophthalmology, Oxford University NHS Trust, Healey Way, Oxford, UK
Interests: age-related macular degeneration; diabetic eye diseases; retinal vein occlusion; macular dystrophy; cataract surgery; visual rehabilitation

Special Issue Information

Dear Colleagues,

In this Special Issue on "Age-Related Macular Degeneration", we would cover major advances in AMD over the past five years, with a mixture of review articles and original articles. The subjects may include the following:

  • Pseudoreticular Durban
  • New therapies of neovascular AMD beyond anti-VEGFs
  • Geographic atrophy
  • Phenotypic classification of AMD
  • OCT-A in AMD
  • Genetics of AMD
  • Nutritional and lifestyle changes and AMD
  • Risk factors for progression of intermediate advanced AMD
  • Pathological/OCT correlation of AMD
  • AMD is a systemic disease?
  • Complement factors and AMD
  • Extracellular matrix and AMD
  • Lipids and AMD
  • Animal models of AMD
  • In vitro models of AMD
  • Gene therapy of AMD—Is that a reality?
  • Autofluorescence (AF) imaging and quantitative AF (qAF) in AMD
  • Hyperspectral imaging of AMD
  • Role of the choroid in AMD, thick and thin
  • Dark adaptation and microperimetry testing in AMD
  • the role of RPE lipofuscin in AMD

All review articles will be invited, but we would be delighted to publish original articles on AMD. We will also consider review articles that are not covered, however, please send us a proposal before a full submission.

Prof. Dr. R. Theodore Smith
Prof. Dr. Victor Chong
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vision is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (7 papers)

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Research

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10 pages, 9421 KiB  
Article
Ex Vivo Hyperspectral Autofluorescence Imaging and Localization of Fluorophores in Human Eyes with Age-Related Macular Degeneration
by Taariq Mohammed, Yuehong Tong, Julia Agee, Nayanika Challa, Rainer Heintzmann, Martin Hammer, Christine A. Curcio, Thomas Ach, Zsolt Ablonczy and R. Theodore Smith
Vision 2018, 2(4), 38; https://doi.org/10.3390/vision2040038 - 26 Sep 2018
Cited by 4 | Viewed by 3110
Abstract
To characterize fluorophore signals from drusen and retinal pigment epithelium (RPE) and their changes in age related macular degeneration (AMD), the authors describe advances in ex vivo hyperspectral autofluorescence (AF) imaging of human eye tissue. Ten RPE flatmounts from eyes with AMD and [...] Read more.
To characterize fluorophore signals from drusen and retinal pigment epithelium (RPE) and their changes in age related macular degeneration (AMD), the authors describe advances in ex vivo hyperspectral autofluorescence (AF) imaging of human eye tissue. Ten RPE flatmounts from eyes with AMD and 10 from eyes without AMD underwent 40× hyperspectral AF microscopic imaging. The number of excitation wavelengths tested was initially two (436 nm and 480 nm), then increased to three (436 nm, 480 nm, and 505 nm). Emission spectra were collected at 10 nm intervals from 420 nm to 720 nm. Non-negative matrix factorization (NMF) algorithms decomposed the hyperspectral images into individual emission spectra and their spatial abundances. These include three distinguishable spectra for RPE fluorophores (S1, S2, and S3) in both AMD and non-AMD eyes, a spectrum for drusen (SDr) only in AMD eyes, and a Bruch’s membrane spectrum that was detectable in normal eyes. Simultaneous analysis of datacubes excited atthree excitation wavelengths revealed more detailed spatial localization of the RPE spectra and SDr within drusen than exciting only at two wavelengths. Within AMD and non-AMD groups, two different NMF initialization methods were tested on each group and converged to qualitatively similar spectra. In AMD, the peaks of the SDr at ~510 nm (436 nm excitation) were particularly consistent. Between AMD and non-AMD groups, corresponding spectra in common, S1, S2, and S3, also had similar peak locations and shapes, but with some differences and further characterization warranted. Full article
(This article belongs to the Special Issue Age-Related Macular Degeneration)
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15 pages, 12433 KiB  
Article
Image Stabilization in Central Vision Loss: The Horizontal Vestibulo-Ocular Reflex
by Esther G. González, Runjie Shi, Luminita Tarita-Nistor, Efrem D. Mandelcorn, Mark S. Mandelcorn and Martin J. Steinbach
Vision 2018, 2(2), 19; https://doi.org/10.3390/vision2020019 - 13 Apr 2018
Cited by 4 | Viewed by 4526
Abstract
For patients with central vision loss and controls with normal vision, we examined the horizontal vestibulo-ocular reflex (VOR) in complete darkness and in the light when enhanced by vision (VVOR). We expected that the visual-vestibular interaction during VVOR would produce an asymmetry in [...] Read more.
For patients with central vision loss and controls with normal vision, we examined the horizontal vestibulo-ocular reflex (VOR) in complete darkness and in the light when enhanced by vision (VVOR). We expected that the visual-vestibular interaction during VVOR would produce an asymmetry in the gain due to the location of the preferred retinal locus (PRL) of the patients. In the dark, we hypothesized that the VOR would not be affected by the loss of central vision. Nine patients (ages 67 to 92 years) and 17 controls (ages 16 to 81 years) were tested in 10-s active VVOR and VOR procedures at a constant frequency of 0.5 Hz while their eyes and head movements were recorded with a video-based binocular eye tracker. We computed the gain by analyzing the eye and head peak velocities produced during the intervals between saccades. In the light and in darkness, a significant proportion of patients showed larger leftward than rightward peak velocities, consistent with a PRL to the left of the scotoma. No asymmetries were found for the controls. These data support the notion that, after central vision loss, the preferred retinal locus (PRL) in eccentric vision becomes the centre of visual direction, even in the dark. Full article
(This article belongs to the Special Issue Age-Related Macular Degeneration)
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11 pages, 2487 KiB  
Article
A Retrospective Analysis of the Effect of Subretinal Hyper-Reflective Material and Other Morphological Features of Neovascular Age-Related Macular Degeneration on Visual Acuity Outcomes in Eyes Treated with Intravitreal Aflibercept over One Year
by King Fai Calvin Leung, Susan M. Downes and Victor Chong
Vision 2018, 2(1), 5; https://doi.org/10.3390/vision2010005 - 31 Jan 2018
Cited by 13 | Viewed by 5366
Abstract
A retrospective study of 176 treatment-naïve eyes with neovascular age-related macular degeneration (nAMD) that had undergone intravitreal aflibercept treatment (2.0 mg, 7–8 times over one year) was performed to correlate the effect of aflibercept on the morphological features of nAMD—subretinal hyper-reflective material (SHRM), [...] Read more.
A retrospective study of 176 treatment-naïve eyes with neovascular age-related macular degeneration (nAMD) that had undergone intravitreal aflibercept treatment (2.0 mg, 7–8 times over one year) was performed to correlate the effect of aflibercept on the morphological features of nAMD—subretinal hyper-reflective material (SHRM), pigment epithelial detachment (PED), subretinal fluid (SRF), and intraretinal fluid (IRF)—with visual acuity at baseline and at one year. Spectral-Domain Optical Coherence Tomography (SD-OCT) images and best-corrected visual acuity (BCVA) at baseline and at one year were obtained. The relationship between visual acuity and the presence of morphological features at baseline and at one year was statistically analysed. The proportion of eyes with PED (p = 0.01), SRF (p ≤ 0.001), and IRF (p ≤ 0.001) reduced at one year. SHRM (p = 0.002) and IRF (p = 0.0001) were associated with poorer baseline BCVA. The presence of SRF at baseline was associated with better baseline BCVA (p = 0.004) and 5.3 letters of improvement of BCVA after one year of treatment (p = 0.0001). For each letter increase in BCVA at baseline, 0.25 fewer letters were gained in BCVA at one year. While aflibercept can improve morphological abnormalities in nAMD, this is not always accompanied by a corresponding improvement in visual acuity. Full article
(This article belongs to the Special Issue Age-Related Macular Degeneration)
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23 pages, 17216 KiB  
Article
Vision Rehabilitation is Part of AMD Care
by August Colenbrander
Vision 2018, 2(1), 4; https://doi.org/10.3390/vision2010004 - 25 Jan 2018
Cited by 2 | Viewed by 12231
Abstract
AMD does not just affect the retina. It severely affects people’s lives. Paying attention to this aspect will only become more important as the population ages and more otherwise healthy individuals become affected. This paper will discuss the need for teamwork to overcome [...] Read more.
AMD does not just affect the retina. It severely affects people’s lives. Paying attention to this aspect will only become more important as the population ages and more otherwise healthy individuals become affected. This paper will discuss the need for teamwork to overcome the difference between medical care, which addresses the causes of AMD, and rehabilitative care, which addresses the consequences. Different aspects and different degrees of vision loss ask for different interventions. Loss of detailed vision can be addressed by a wide variety of magnification devices. The means to address this aspect are well recognized. Surround vision is largely processed pre-attentively. Its loss cannot be remediated by devices, but must be addressed through patient education to bring previously subconscious reactions to conscious awareness. Loss of contrast vision is an aspect that is not sufficiently studied. It is important for early detection, and for the safety of the patient. When the eye condition cannot be modified, environmental modifications provide the most effective remediation. Full article
(This article belongs to the Special Issue Age-Related Macular Degeneration)
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821 KiB  
Article
Peripapillary Retinal Nerve Fiber Measurement with Spectral-Domain Optical Coherence Tomography in Age-Related Macular Degeneration
by Simon K. Law, Kent W. Small and Joseph Caprioli
Vision 2017, 1(4), 26; https://doi.org/10.3390/vision1040026 - 14 Dec 2017
Cited by 2 | Viewed by 3059
Abstract
Purpose: To evaluate the relationship between the peripapillary retinal nerve fiber layer (RNFL) measurements with Spectral-domain Optical Coherence Tomography (OCT) and Age-related macular degeneration (AMD). Methods: Patients >60 years of age without glaucoma or record of intraocular pressure >21 mmHg and no systemic [...] Read more.
Purpose: To evaluate the relationship between the peripapillary retinal nerve fiber layer (RNFL) measurements with Spectral-domain Optical Coherence Tomography (OCT) and Age-related macular degeneration (AMD). Methods: Patients >60 years of age without glaucoma or record of intraocular pressure >21 mmHg and no systemic or intraocular diseases or treatment or surgical intervention that affected the RNFL underwent OCT measurement of the RNFL. The severity of AMD was staged with the Clinical Age-Related Maculopathy Staging System. The relationship between RNFL measurements and AMD stages of one eye per patient was analyzed. Results: Eighty-six eyes (46 patients) with AMD and no glaucoma or other exclusion criteria received OCT RNFL measurements. Nine eyes (10.5%) were excluded because of distorted peripapillary anatomy from exudative AMD (7 eyes) or failure of the RNFL segmentation algorithm (2 eyes). Mean age ± S.D. of the 43 patients analyzed was 81.2 ± 7.3 years. The mean stage ± S.D. of AMD of the 77 eyes was 3.77 ± 1.05. Higher stages of AMD were statistically significantly associated with lower average RNFL and inferior sector RNFL (p = 0.049, 0 0015, respectively). The association of inferior sector RNFL and AMD stage remained statistically significant after adjusting for age. Conclusions: Spectral domain OCT is generally useful in measuring the peripapillary RNFL in eyes with different stages of AMD. Higher stage of AMD is associated with thinner peripapillary RNFL, which may masquerade as early glaucomatous damage. Full article
(This article belongs to the Special Issue Age-Related Macular Degeneration)
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Review

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16 pages, 536 KiB  
Review
New Therapies of Neovascular AMD—Beyond Anti-VEGFs
by Praveen Yerramothu
Vision 2018, 2(3), 31; https://doi.org/10.3390/vision2030031 - 30 Jul 2018
Cited by 15 | Viewed by 4975
Abstract
Neovascular age-related macular degeneration (nAMD) is one of the leading causes of blindness among the aging population. The current treatment options for nAMD include intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF). However, standardized frequent administration of anti-VEGF injections only improves vision in [...] Read more.
Neovascular age-related macular degeneration (nAMD) is one of the leading causes of blindness among the aging population. The current treatment options for nAMD include intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF). However, standardized frequent administration of anti-VEGF injections only improves vision in approximately 30–40% of nAMD patients. Current therapies targeting nAMD pose a significant risk of retinal fibrosis and geographic atrophy (GA) development in nAMD patients. A need exists to develop new therapies to treat nAMD with effective and long-term anti-angiogenic effects. Recent research on nAMD has identified novel therapeutic targets and angiogenic signaling mechanisms involved in its pathogenesis. For example, tissue factor, human intravenous immune globulin, interferon-β signaling, cyclooxygenase-2 (COX-2) and cytochrome P450 monooxygenase lipid metabolites have been identified as key players in the development of angiogenesis in AMD disease models. Furthermore, novel therapies such as NACHT, LRR and PYD domains containing protein 3 (NLRP3) inflammasome inhibition, inhibitors of integrins and tissue factor are currently being tested at the level of clinical trials to treat nAMD. The aim of this review is to discuss the scope for alternative therapies proposed as anti-VEGFs for the treatment of nAMD. Full article
(This article belongs to the Special Issue Age-Related Macular Degeneration)
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5 pages, 184 KiB  
Review
New Therapies of Neovascular AMD beyond Anti-VEGF Injections
by Greggory M. Gahn and Arshad M. Khanani
Vision 2018, 2(1), 15; https://doi.org/10.3390/vision2010015 - 19 Mar 2018
Cited by 10 | Viewed by 3747
Abstract
Neovascular age-related macular degeneration is a leading cause of vision loss among the aging population. The current standard of care to treat neovascular age-related macular degeneration is inhibiting vascular endothelial growth factor (VEGF) through intravitreal injections. Recent studies have demonstrated that the tyrosine [...] Read more.
Neovascular age-related macular degeneration is a leading cause of vision loss among the aging population. The current standard of care to treat neovascular age-related macular degeneration is inhibiting vascular endothelial growth factor (VEGF) through intravitreal injections. Recent studies have demonstrated that the tyrosine kinase with immunoglobulin-like and epidermal growth factor-like domains 2 (Tie2) pathway also plays a critical role in angiogenesis and vascular stability. Additionally, newly developed treatment delivery systems have been designed to greatly reduce the frequency of injections. In targeting the Tie2 pathway and utilizing a sustained release delivery system, patients may experience improved visual outcomes and a reduced burden of treatment. Full article
(This article belongs to the Special Issue Age-Related Macular Degeneration)
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