Macular Degeneration, Age Related

Abstract Macular degeneration comprises a group of diseases characterised by progressive deterioration of the retinal photoreceptors, retinal pigment epithelial cells and underlying choriocapillaris, causing progressive central vision loss. The most common form of macular degeneration is age‐related macular degeneration (AMD), the leading cause of irreversible blindness among elderly patients in developed countries. Other types of hereditary early‐onset macular dystrophies share clinical characteristics with AMD, but a monogenetic basis for many of these conditions has been found. Recent advances in clinical and genetic research have led to a better understanding of the genetics and pathophysiology of AMD, which is currently viewed as a complex disorder in which multiple susceptibility genes combined with environmental factors play a role. The management of neovascular AMD has changed dramatically with the introduction of anti‐VEGF drugs, but treatment options for other types of macular degeneration remain limited because the aetiology and pathogenesis are incompletely defined. Key Concepts Macular degeneration refers to a group of diseases characterised by photoreceptor cell degeneration and death, leading to central vision loss. Recent advances in optical coherence tomography (OCT) technology have led to its major role in diagnosis and management of macular degeneration. Monthly follow‐up of patients with neovascular AMD is recommended for best visual outcome. Regular anti‐VEGF therapy with intravitreal injections of ranibizumab, aflibercept or bevacizumab is currently considered to be the standard treatment for neovascular AMD. Ongoing clinical trials are investigating the efficacy and safety of combination treatments for neovascular AMD and treatments for other forms of macular degeneration. Research efforts are directed at prevention of AMD and stem cell and gene therapy treatments for Stargardt disease.