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Purpose of review The purpose of this review is to describe the current clinical landscape of potential future therapies for both nonexudative (dry) and exudative (wet) age-related macular degeneration (AMD). We highlight some of the more promising treatments that are furthest along in development. Recent findings Patients with dry AMD have long been hoping for a highly efficacious treatment that may slow disease progression or even help regain vision. Patients with wet AMD have many effective treatment options but still there are those who have suboptimal responses or are burdened by the high frequency of treatment. We detail exciting new concepts and targets for novel medications. Specifically, for dry AMD we discuss research looking at complement inhibition, neuroprotection, visual cycle modulators, cell-based therapies, and anti-inflammatory agents. For wet AMD we summarize new, potentially more durable anti-vascular endothelial growth factor agents, extended release options, and gene therapy. Summary There are promising new strategies for AMD. Many of the potential new treatments are in or have recently completed phase 2 or phase 3 clinical trials with promising results thus far, including some that have received US Food and Drug Administration approval. Additional therapeutic breakthroughs will likely continue to occur thanks to the number of clinical trials that are nearing the finish line.

Purpose of review The purpose of this report is to review recent literature and ongoing clinical trials of the treatment of neovascular age-related macular degeneration. Recent findings Advances in the understanding of the pathogenesis of age-related macular degeneration and choroidal neovascularization have resulted in the emergence of pharmacotherapies targeting various aspects of angiogenesis. Preliminary results with the new agents have been encouraging. Moreover, longer follow-up and subgroup analyses of the Treatment of Age-Related Macular Degeneration with Photodynamic Therapy and Verteporfin in Photodynamic Therapy studies have suggested new potential indications for photodynamic therapy. Summary Currently a patient with wet macular degeneration may have multiple investigational options that were unavailable several years ago. Ongoing clinical trials are aimed at determining the long-term safety and efficacy of these new pharmacologic and combination therapy modalities.

Photodynamic therapy is a relatively selective form of treatment for choroidal neovascularization. Unlike standard laser photocoagulation, photodynamic therapy can close choroidal neovascularization with minimal or no detectable damage to surrounding tissues. Therefore, it allows the clinician to treat subfoveal choroidal neovascularization without immediately adversely affecting central visual function. Several dyes for photodynamic therapy have been under various stages of formal clinical investigation. There is now mounting evidence that shows that photodynamic therapy with at least one of these dyes can significantly reduce the risk of visual loss in eyes with subfoveal choroidal neovascularization from age-related macular degeneration. This form of treatment promises to have a major, favorable impact on public health in areas of the world in which age-related macular degeneration is common.

Most cases of X-linked juvenile retinoschisis and degenerative retinoschisis never require any type of surgical intervention. However, on rare occasions, associated problems such as retinal detachment come about and threaten the visual prognosis. Both conditions have in common the adherence of cortical vitreous to the inner layer of peripheral schisis cavities, which can make the secondary complications technically difficult to manage. Although good surgical results can often be obtained, it is not unusual to require relatively advanced vitreoretinal techniques to achieve long-term surgical success.

Purpose of review This report reviews the current treatment strategies and the most recent clinical trials in the treatment of neovascular age-related macular degeneration. Recent findings The functional and anatomic outcomes achieved in the pivotal ranibizumab trials with monthly injections set the standard for comparison. Since then, various modified dosing regimens with the aim of lessening the treatment burden associated with monthly injections have been investigated. Additionally, level I evidence now exists for the noninferiority of bevacizumab, as compared to ranibizumab, in the treatment of neovascular age-related macular degeneration (AMD) through 1 year of follow-up. Aflibercept has emerged as a new anti- vascular endothelial growth factor (VEGF) therapy showing encouraging treatment results at 1 year. Novel treatments combined with anti-VEGF agents such as localized radiation are currently being investigated. Summary Anti-VEGF monotherapy remains the preferred therapy for the management of neovascular AMD at the present time. Aflibercept is a new, FDA-approved, effective, anti-VEGF agent available for clinical use. Ongoing clinical trials will help determine the optimal dosing regimens for all of these agents, as well as the long-term efficacy and safety of combination therapy modalities.

A review of the current literature regarding the ocular manifestations and management of graft versus host disease is presented.A variety of systemic and topical anti-inflammatory or immunomodulatory agents, including prednisolone acetate, cyclosporine A, FK506, autologous serum, and retinoic acid show promise in controlling ocular graft versus host disease.Graft versus host disease is a common manifestation of allogeneic stem cell transplantation. Ocular manifestations are found in a majority of patients and may be the presenting symptom. Ocular findings include keratoconjunctivitis sicca, pseudomembranous conjunctivitis, corneal ulceration and perforation, and microvascular retinopathy. Systemic and local therapy may be used to control ocular disease.