Macular Degeneration: Current Concepts and Treatment Modalities

Mark Mandelcorn, MD, FRCS(C)
Vitreo-retinal Surgeon
Toronto Western Hospital

Macular degeneration (MD) is the leading cause of legal blindness in the Western world, the leading cause of poor eyesight in Canada, and has been described as one of the great 'epidemics' of the twentieth century. The Canadian National Institute for the blind registers almost 50,000 people as legally blind as a result of MD. This month, Geriatrics & Aging is very pleased to present an article by Dr. Mark Mandelcorn, a leading vitreo-retinal surgeon, on the various treatment options that are available for patients suffering from MD.

Macular degeneration is the most likely diagnosis when an elderly patient has poor reading vision that cannot be corrected with either glasses or cataract surgery. Not all cases presenting in this way, however, constitute true macular degeneration, currently referred to as age-related macular degeneration (AMD). Some may, in fact, be cases of macular hole; others could be premacular fibrosis; finally, a case resembling macular degeneration may actually be related to a systemic disorder, such as, diabetic macular edema.

It is important to be certain that the disorder is true age-related macular degeneration. In the case of AMD, the prognosis and management of the affected eye are entirely different and perhaps more difficult, and the fate of the other eye more uncertain, than would be the case with any of the other disorders mentioned above.