The significance of early detection of age-related macular degeneration: Richard & Hinda Rosenthal Foundation lecture, The Macula Society 29th annual meeting

BACKGROUND: The main cause for visual loss in age-related macular degeneration (AMD) is the development of choroidal neovascularization (CNV), which has been shown to occur in 18% of patients over 5 years. Even though satisfactory treatments for CNV are available, in the majority of cases no improvement in visual acuity occurs and in those it does it is mostly limited. Early detection has the potential of significantly improving the final visual outcome of patients who develop subfoveal CNV. METHODS: This review is a summary of the importance of early detection in the management of AMD, in view of the current available treatment methods. It is a review of the results of early detection of AMD using the Preferential Hyperacuity Perimeter (PHP). RESULTS: Awareness for symptoms, use of the Amsler grid and monitoring by an ophthalmologist are not satisfactory means for early detection of AMD. The PHP has good sensitivity and specificity in detecting CNV patient early and differentiate them from intermediate AMD. CONCLUSION: In an era of excellent treatments available for CNV treatment, early detection of CNV by novel technology modalities such as the PHP at a frequency that allows early detection (approximately 4 times a year) is crucial in the armamentarium of AMD patient management.