New developments in age-related macular degeneration

The World Health Organization (WHO) estimates that over 3 million people (9% of global blindness) are blinded by age-related macular degeneration (AMD). AMD affects people over the age of 55. There are two main types of AMD, dry and wet. In dry AMD, patients slowly lose vision through progressive atrophy of the macular tissue. Wet, or exudative, AMD, is associated with new blood vessels called subretinal neovascular membranes (or SRNVM) and affected patients lose vision more rapidly due to fluid leakage and haemorrhage at the macula

The Argus II Retinal Prosthesis System

The field of retinal prosthetics has seen significant advances in the past 3 decades. Encouraging results from different groups have shown coarse objective functional improvement, using a range of technological and surgical approaches. The Argus II retinal prosthesis system was the first of its kind to receive regulatory approval for commercial use in Europe and the USA. The device is designed to replicate the function of photoreceptors in converting visual information into electrical neural signals in patients with profound visual loss secondary to degenerative retinal disease. Results from a phase II study of 30 patients have demonstrated improved performance in basic tests of visual function, object recognition, letter reading, prehension, orientation and mobility tasks. It is now the most widely implanted retinal prosthetic device worldwide. This chapter provides an overview of the requirements of a retinal prosthetic system, the results from the Argus II device to date, and an insight into some of the challenges and future directions of visually restorative therapies

Intraocular Biopsy and ImmunoMolecular Pathology for "Unmasking" Intraocular Inflammatory Diseases

Intraocular inflammation can hide a variety of eye pathologies. In 33% of cases, to obtain a correct diagnosis, investigation of the intraocular sample is necessary. The combined analyses of the intraocular biopsy, using immuno-pathology and molecular biology, point to resolve the diagnostic dilemmas in those cases where history, clinical tests, and ophthalmic and systemic examinations are inconclusive. In such situations, the teamwork between the ophthalmologist and the molecular pathologist is critically important to discriminate between autoimmune diseases, infections, and intraocular tumors, including lymphoma and metastases, especially in those clinical settings known as masquerade syndromes. This comprehensive review focuses on the diagnostic use of intraocular biopsy and highlights its potential to enhance research in the field. It describes the different surgical techniques of obtaining the biopsy, risks, and complication rates. The review is organized according to the anatomical site of the sample: I. anterior chamber containing aqueous humor, II. iris and ciliary body, III. vitreous, and IV. choroid and retina. We have excluded the literature concerning biopsy for choroidal melanoma and retinoblastoma, as this is a specialized area more relevant to ocular oncology

Applications of three-dimensional printing in ophthalmology

Three-dimensional (3D) printing is increasingly used to produce customised objects and is a promising alternative to traditional manufacturing methods in diverse fields, such as dentistry and orthopaedics. Already in use in other medical specialities, adoption in ophthalmology has been limited to date. This review aims to provide an overview of 3D printing technology with respect to current and potential applications in ophthalmic practice. Medline, Embase and internet search were performed with "3D printing", "ophthalmology", "dentistry", "orthopaedics" and their synonyms used as main search terms. In addition, search terms related to clinical applications such as "surgery" and "implant" were employed. 3D printing has multiple applications in ophthalmology, including in diagnosis, surgery, prosthetics, medications and medical education. Within the past decade, researchers have produced 3D printed models of objects such as implants, prostheses, anatomical models and surgical simulators. Further development is necessary to generate optimal biomaterials for various applications, and the quality and long-term performance of 3D models needs to be validated