What’s in a name? Since the first description of age-related macular degeneration in 1874 as “Symmetrical central choroido-retinal disease occurring in senile persons”, 1 over 20 different names have been given to this disorder, often reflecting the pathophysiological thinking at a certain time. Because there was need for an internationally accepted classification, the International ARM Epidemiological Study Group named all signs of age-related macular changes age-related maculopathy (ARM), and its end stages, age-related macular degeneration (AMD) following the convention at that time.2 Both the laymen and the medical public found these two names confusing, so gradually all ARM was called AMD, to be divided in early and late AMD. Recently it was proposed to use AMD as an acronym for “Aging Macula Disorder”, essentially the same disease as age-related macular degeneration, for the following reasons.3 Age-related does not differentiate between juvenile macular disease and that associated with old age. Aging better describes the process of becoming older. Although AMD is a complex disorder with a large genetic component, the lifelong changes in the retinal pigment epithelium (RPE) and surrounding tissues in the macula seem a key component in its pathogenesis. Patients do not like to hear associations with senility anymore, nor with degeneration. Finally, it is not clear if and when early or late AMD becomes a disease, therefore we prefer calling it a disorder. Thus we opted for using aging macula disorder as the basis for AMD in this thesis.

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The publication of this thesis was financially supported by the Department of Epidemiology & Biostatistics of the Erasmus Medical Center, Rotterdam; Alcon BV, Groningen; Allergan BV, Nieuwegein; Dutch Ophthalmic Research Center, Zuidland; Ergra Low Vision, Den Haag; Laméris Ootech BV, Nieuwegein; Landelijke Stichting voor Blinden en Slechtzienden, Utrecht; Merck Sharp & Dohme BV, Haarlem; Pfizer BV, Capelle aan de IJssel.
P.T.V.M. de Jong (Paulus) , A. Hofman (Albert)
Erasmus University Rotterdam
Erasmus MC: University Medical Center Rotterdam