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The introduction of OCT for the clinical examination of the macula has opened up several new avenues in the diagnosis and monitoring of cystoid macular oedema. This novel technique has become of particular importance in the assessment of diabetic macular oedema and of macular oedema associated both with age-related macular degeneration and with vitreomacular traction syndromes. It has added new diagnostic criteria as well as more objective data both to make informed therapeutic decisions and to monitor macular oedema after applied treatment. Novel technologies such as ultrahigh-resolution OCT, which uses a titanium-sapphire laser light source, may play an important role in the future by providing much needed increased image resolution of up to 3 μm. This technology will be particularly useful in the exact localization of subfoveal or sub-RPE choroidal neovascular membranes with important consequences for their medical or surgical management.

Ophthalmic imaging technology has revolutionized fundus examination. FAF imaging represents one of various novel tools and provides information over and above fundus photography, fluorescence angiography and optical coherence tomography. This noninvasive diagnostic tool visualizes age- and disease-related metabolic changes of the retinal pigment epithelium. The autofluorescence signal mainly derives from dominant fluorophores in lipofuscin granules of the RPE. Lipofuscin accumulation represents a common downstream pathogenetic pathway in many retinal and macular disease entities.Thus FAF imaging contributes significantly to our understanding of the pathophysiology and treatment of various retinal diseases.

From the time when early investigators were vexed by “the peculiar lines in the choroid” until today, much has been learned about the clinical presentation of choroidal folds. The astute clinician not infrequently will detect choroidal folds during the course of a comprehensive retinal examination. Benign and ominous aetiologies exist and will guide the management. Bilateral choroidal folds are usually benign and the result of idiopathic acquired hyperopia and do not typically require extensive investigation. Unilateral choroidal folds are typically associated with vision compromising aetiologies the diagnosis of which is usually apparent.

Based on the results of the ARED study, a prophylactic treatment with a combination of vitamin C, vitamin E, β-carotene, and zinc is recommended for patients meeting the fundoscopic criteria described as categories 3 and 4 in the study. For all other nutritional supplementation including lutein or zeaxanthin,which increase macular pigment density, there is as yet no proven efficacy with regard to the prevention of AMD. However, many new antiangiogenic therapies are currently under investigation in large multicentre trials and hold exciting potential for patients with neovascular AMD. Further insight into the angiogenic process and its inhibition may lead to more targets that may be transferred for use in patients with neovascular AMD.