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Diagnosis and treatment of macular pathology

The macula represents a small part of the retina, but it is much more sensitive to detail than the rest of the retina. It occupies the central area of the retina, and it is the specific region which allows us to see subtle details. A macula in good condition makes it possible to do activities such as thread a needle, read tiny letters, or watch TV. This can be compromised with macular pathology.
The peripheral retina, which is the rest of the retina, is what allows us to have lateral vision and helps us to see ‘visual field’. It also helps you see movement and shapes in our lateral vision, but without colour. That is why it is essential to maintain good central vision, as we are all so dependent on it.
Due to its importance, macular pathology is experiencing significant changes regarding diagnostic methods and treatment. We are now recognising more types of maculopathy, such as myopic maculopathy, the hereditary retinal dystrophies, like retinitis pigmentosa, the atrophic AMD (age-related macular degeneration) and post intra-ocular surgery, such as cataract surgery, where there may be a temporary macular oedema and reduced central vision.

Developments in the diagnosis of macular pathology

Regarding diagnostic approach, there are new techniques available which include more than the OCT and the scanning laser ophthalmoscopy (the Optos Californian). Increasingly, with research, there are now ultra-high definition OCT’s that enable the reconstruction of an image of the layers of the retina and the layers of the choroid. These layers feed the retina and help lead us to understand the diseases of the macula better and to target therapies. The assessment and treatment of macular disorders continue to march ahead.
At Clinica London, Professor Michel Michaelides is our leading macular ophthalmologist who works at the UCL Institute of Ophthalmology, Moorfields Eye Hospital, and also sees patients privately at Clinica London. He specialises in both acquired (age-related, diabetes and drug toxicity-related) and inherited diseases that involve the macula, such as Retinitis Pigmentosa, Stargardt disease, cone dystrophies, Leber Congenital Amaurosis, etc., both in adults and children. He is highly involved in several multinational investigative trials and is assisting in the development of gene and non-gene directed therapies to ease a significantly slow, or halt disease progression.

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