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Retinal imaging is the basis of macular disease's diagnosis. Currently available technologies in clinical practice are
fluorescein and indocyanin green (ICG) angiographies, in addition to optical coherence tomography (OCT), which is an in
vivo "histology-like" cross-sectional images of the retina. Recent developments in the field of OCT imaging include
Spectral-Domain OCT. However OCT remains a static view of the macula with no direct link with dynamic observation
obtained by angiographies. Adaptative optics is an encouraging perspective for fundus analysis in the future, and could be
linked to OCT or angiographies.
Treatments of macular disease have exploded these past few years. Pharmacologic inhibition of angiogenesis
represents a novel approach in the treatment of choroidal neovascularization in eyes with age-related macular degeneration.
The major action explored is the direct inhibition of the protein VEGF with antibody-like products. New anti-VEGF drugs
are in development aiming at the VEGF receptors or synthesis of VEGF. But various components of the neovascular cascade,
including growth factor expression, extracellular matrix modulation, integrin inhibition represent potential targets for
modulation with drugs.
Intra-vitreal injections are nowadays the main route of administration for these new treatments but they are
potentially responsible of side effects such as endophtalmitis. Development of other routes of treatment would require new
formulation of used drugs. The improvement of retinal imaging leads to a better understanding of macular disease
mechanisms and will help to develop new routes and targets of treatment.
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