Diseases of the Macula: A Practical Approach, Jack J. Kanski, Stanislaw A. Milewski. St. Louis: Mosby, Inc. , 2002. Pages: 280. Price: 79. 95. ISBN 0-7234-3241-4 In the preface, the authors state that the purpose of this text is to provide a practical yet didactic approach to the diagnosis and management of macular disorders. They excluded peripheral retinal conditions, retinopathy of prematurity, and effects of tumors on the macula. They point out that the text is intended for general ophthalmologists, ophthalmology residents, and optometrists. Material is presented in a very familiar Kanski style with photographs, diagrams, and supplemental text. Finally, the authors prioritized the order of conditions in each chapter based on their prevalence and added case studies after some clinical topics to enhance understanding of the reader. This is a skinny hardbound text that can easily be referenced in an examination or consultation area. Chapter 1, Introduction, contains six sections. Sections one and two contain excellent discussions about macular anatomy and methods of evaluation. There is a good balance of print and diagrams that facilitate review of key items in an efficient manner. Section three provides a detailed review of fluorescein angiography (FANG) with excellent representative photographs to display key concepts of hyper- and hypofluorescence. Section four highlights general principles for indocyanine green angiography (ICGA). The videographs in this section do not lend much to understanding this topic better. ICGA examples of normal choroidal circulation versus abnormal choroidal circulation would have made this section much more useful to the reader. With that said, it was good to see this material to compare FANG against ICGA and indications for each. The next section on electrophysiological tests, which included electroretinography (ERG) and electro-oculography (EOG), was good to see but the content was brief and not as useful to me as I would have liked. There was very limited content on normal versus abnormal findings and effective clinical application of each test. The final section of this chapter contained a brief discussion about laser photocoagulation. This section provides enough background information about this concept for the nonsurgical eye care professional to interact effectively with the surgical eye care professional and to highlight key principles to patients prior to referral visits for treatment. Chapter 2, Acquired Macular Disorders, contains 13 sections covering clinical entities encountered commonly in practice such as age-related macular degeneration to the uncommon such as idiopathic polypoidal choroidal vasculopathy. The authors do a good job of indicating frequency of disease occurrence for each condition covered, which provides perspective for even a notice eye care professional. Most topics from this chapter forward are discussed in a similar format containing presentation, signs, workup, treatment, and visual prognosis. The photographic representations are very good with a nice blend of histopathological photographs and visual aids from current technology such as optical coherence tomography when indicated. At the conclusion of some sections in this chapter, case studies are used to provide further understanding of clinical presentation, workup, and management time course. These items may be very useful to eye care professional in discussions with patients about visual expectations and outcomes. Each section also ends with further reading recommendations, which contain relevant and recent well-designed studies from mostly ophthalmologic literature. Chapter 3, Retinal Vascular Disorders, follows a similar pattern to the previous chapter. There are 10 sections that cover clinical entities from diabetic retinopathy to Purtscher retinopathy. The photographs again are excellent and many have corresponding FANGs. A couple of pages of section 1 is devoted to peripheral retinal photocoagulation (PRP) sequence technique. Four figures containing 12 diagrams total specify the sequence of retinal burns when PRP is performed. For example, retinal burns are applied inferior to the optic disk first and are placed systematically throughout the posterior pole and midperiphery of all retinal quadrants to manage proliferative diabetic retinopathy. Diagrammatic explanations of this type can greatly enhance patient-to-doctor discussions about PRP expectations and outcomes prior to referral. Again, case studies and further reading lists are found throughout the chapter to facilitate under-standing. Chapter 4, Inflammatory Fundus Disorders, contains 20 sections for a comprehensive listing of potential causes of retinal or chorioretinal inflammation. The photographic representations of each condition are numerous and of high quality. This chapter also contains brief discussions about more obscure, recently recognized clinical entities such as acute zonal outer retinopathies. It is nice to see explanations, although brief, about conditions infrequently encountered in practice to decide whether to include or not include on a differential diagnosis list. Case studies are also included with select conditions to solidify the message. Chapter 5, Hereditary Fundus Dystrophies, contains 21 sections outlining conditions that will be encountered infrequently in practice such as retinitis pigmentosa and those very uncommon conditions only encountered in specialty tertiary settings such as Alport syndrome or cherry-red spot at macula syndromes. There are no case studies included in this chapter, but there are references in each section for the reader to investigate the topic further if desired. In summary, this book is what I have been looking for in a text about maculopathies to supplement some of the other references I have collected over the years. The quality of the images and scope of content made me decide to purchase it, and the price for such a nice text was a bonus. This text will serve me well in my clinical teaching duties for years to come.
Cynthia H. Green (Fri,) studied this question.