Age-related macular disease : studies on incidence, risk factors, and prognosis

Age-related macular disease (AMD) is a new name, recently coined by Bird,25 for a progressive and degenerative disease in elderly persons affecting the macula lutea. Dysfunction of this part of the retina, and especially its centre, the fovea, results in the inability to read, recognize faces, drive, and move freely. Bird proposed to substitute the word disease for degeneration, probably due to the pejorative ring of the latter and because the word degeneration does not cover all pathological processes thought to play a role in AMD. According to the current nomenclature of the International AMD Epidemiological Study Group, all early and late signs of AMD are called age-related maculopathy (ARM), while age-related macular degeneration indicates the two late stages of ARM.24 These are the dry type, also called geographic atrophy, and the wet type, also called neovascular or disciform AMD. The wet type often leads to rapid loss of central vision while this may take years for the dry type. The oldest image of disciform AMD, as far as we know, is from 1875 by Pagenstecher and Genth, while Haab was in 1885 the first to describe the dry type of AMD that he called senile macular degeneration. I decided to follow Bird’s example in the title of this thesis and used the word disease instead of degeneration. However, the reader will find in the remainder of this book the term ARM and AMD in the conventional sense, because most articles included in the thesis were written at a time that we still used ARM as the common denominator for this disease.

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