Age-related maculopathy: pathogenetic features and new treatment modalities

A considerable amount of new information on putative pathogenetic mechanisms in age-related maculopathy and degeneration has emerged in recent years. This comprises experimental studies on retinal pigment epithelium (RPE) and rod photoreceptor ageing, lipofuscin accumulation, the roles of oxidative stress and free radical formation, as well as antioxidants and other defensive mechanisms operating against environmental factors and ageing. The current application of photodynamic therapy (PDT) using verteporfin marks a new era in the treatment of subfoveal classical choroidal neovascularization. Several new treatment modalities, such as transpupillary thermotherapy (TTT) and anti-vascular endothelial growth factor (VEGF) agents for inhibition of neovascularization, have emerged and are undergoing multicentre clinical trials. A period of dynamic development in this field has commenced.