Nonpharmacologic Therapy

Non-neovascular AMD

Advise patients to stop smoking as observational data support a causal relationship

between smoking and AMD.

Drusen ablation by laser has been used in non-neovascular AMD. However, it is not clear if the treatment reduces progression to neovascular AMD. There is a pos-

sibility that the treatments may induce neovascularization and retinal atrophy. Other nonpharmacologic therapies are in trials but there is insufficient evidence for experts

to recommend these procedures at this time. Neovascular AMD

Thermal laser photocoagulation reduces severe visual loss 2 to 5 years after the procedure, but leads to an immediate and permanent reduction in central vision. There is

a 50% chance that leakage will recur in the next 2 years after the procedure.

Photodynamic therapy uses nonthermal red light to activate verteporfin, which pro-

duces reactive oxygen species that locally damage the neovascular endothelium. Verteporfin treatment reduces the risk of loss of visual acuity and legal blindness over 1 to 2 years. Long-term results are not yet available. Severe photosensitivity for 3 to 5 days after the procedure is common and some patients experience a severe loss of vision. Eventually, most patients have some visual recovery. This procedure requires multiple treatments over time.25 Other nonpharmacologic therapies are in trials but there is insufficient evidence for experts to recommend these procedures at this

time.22

A Disquistion On The Evils Of Using Tobacco

A Disquistion On The Evils Of Using Tobacco

Among the evils which a vitiated appetite has fastened upon mankind, those that arise from the use of Tobacco hold a prominent place, and call loudly for reform. We pity the poor Chinese, who stupifies body and mind with opium, and the wretched Hindoo, who is under a similar slavery to his favorite plant, the Betel but we present the humiliating spectacle of an enlightened and christian nation, wasting annually more than twenty-five millions of dollars, and destroying the health and the lives of thousands, by a practice not at all less degrading than that of the Chinese or Hindoo.

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