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Garner and Klintworth's Pathobiology of Ocular Disease

3rd Edition, March 27, 2008

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ISBN: 978-1-4200-2097-7
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Product Details:

  • Revision: 3rd Edition, March 27, 2008
  • Published Date: March 27, 2008
  • Status: Active, Most Current
  • Document Language: English
  • Published By: CRC Press (CRC)
  • Page Count: 1751
  • ANSI Approved: No
  • DoD Adopted: No

Description / Abstract:

Preface to the Third Edition

Pathology at the clinical level is principally concerned with diagnosis, and rightly so. But it has an even deeper significance, which stems from its very definition. Pathology is the study of disease. In other words, it is fundamentally concerned with the processes underlying the clinical manifestations of disease. This is the principle we have tried to uphold in putting the present compilation together.

What is unique about this book? Before providing an answer, let us consider other books on ophthalmic pathology. Several are designed for the trainee in clinical ophthalmology and focus on clinically relevant information that examiners require of persons taking professional examinations. Such books are valuable to persons intent on persuading their examiners that they know enough pathology to be allowed to practice clinical ophthalmology. Other books provide a manual of diagnostic ophthalmic pathology and concentrate on descriptive morphology and are often extensively illustrated. Garner and Klintworth's Pathobiology of Ocular Disease, Third Edition, contains some elements of both of these types of books, but it goes far beyond material necessary to pass examinations or diagnose disorders based on morphologic criteria. Morphology continues to be the bedrock in defining the pathology of any disorder and, where appropriate, our contributors have not shied away from spelling out the clinical and histological aspects of the conditions they describe. But because pathology goes far beyond morbid anatomy, they have sought, where possible, to use these definitions as a basis for describing the underlying cellular events at a molecular level.

Back in the 1960s, when the editors were learning the trade, knowledge about eye diseases was proving elusive, largely from lack of appropriate methods of investigation. But since then the introduction of such techniques as electron microscopy, precise histochemical stains, and tissue and cell culture revolutionized the functional appreciation of a multitude of diseases. The revolution has continued unabated with the application of extremely sophisticated molecular biology techniques able to exploit an ever-expanding understanding of cytogenetics and immunology.

In the preface to the first edition of a muchvalued textbook on pathology that was current when the editors of this book were medical students (1), we were reminded that, "Pathology is the elucidation of the vital processes which underlie the end-results studied by the morbid anatomist. It is the study of disease from the physiological point of view." Indeed, this has always been the real goal of the pathologist, a point purportedly made more than a hundred years ago by the distinguished surgeon, scientist, and onetime professor of pathology, Sir Victor Horsley (1857–1916), who was intent on pushing back the limitations of clinical practice when he wrote, "What is currently thought of as pathology is nothing of the sort—it is morbid anatomy. The pathologist should be a student of disordered function." It is to this understanding of ophthalmic pathology that we and our contributors have been committed in this multi-disciplinary book purposely titled, Pathobiology of Ocular Disease.

As with the two earlier editions, the book was designed with the ophthalmic practitioner in mind to provide, as far as is possible, an appreciation of the processes responsible for producing the disorders observed in hospital clinics and consulting rooms. While therapy is not considered because of space restrictions and the fact that it is often empirical, the information provided about the cause and basic mechanisms of specific diseases provides insight into potential therapeutic approaches. The effective rational therapy of any disease must be derived from a sound understanding of the underlying basic mechanisms.

In the decade that has intervened since the last edition, major advances have been made, particularly in the realms of molecular biology, cytogenetics, computerized databases, and, more recently, in molecular genetics. The ability to amplify DNA with the polymerized chain reaction, to sequence the human genome, and to identify specific proteins in different tissues with the highly sensitive matrixassisted laser desorption ionization–time of flight mass spectrometry has played an important role in furthering knowledge. The study of ocular disease has shared in this advance, and the findings have impinged on the etiology and pathogenesis of many ocular diseases. This knowledge has expanded exponentially, largely as a result of research by scientists with a wide variety of techniques and the rapid dissemination of information on the Internet.

Such has been the increase in knowledge that several chapters were completely revamped and several new chapters added. The vast increase in knowledge about the genetics of many ocular diseases spawned specific chapters dealing with molecular genetic aspects of glaucoma and cataracts, as well as corneal, retinal, and optic nerve disease. Other new chapters focus on the molecular pathways of apoptosis, wound healing, the vasculitides, aging, age-related maculopathy, the aging lens, myopia, and amblyopia.

In the first edition we diligently avoided abbreviations, despite their emerging popularity in biomedical publications. By the second edition, abbreviations were unavoidable, and in this new edition the number increased immensely, largely due to the use of acronyms and conventions that have arisen regarding the nomenclature of the vast number of identified genes and their encoded proteins. When possible, we used accepted abbreviations that have come into common usage among experts who are furthering knowledge about diseases. For example, for consistency we used italicized uppercase letters for human genes and non-italicized letters for the protein products. Mouse genes that are involved in many animal models of ocular diseases are designated according to the accepted format of lowercase italicized letters. For readers not familiar with abbreviations, we have insisted that they be defined the first time that they are used in each chapter, and for the ease of finding the definition, the separate section on abbreviations has been retained. Hopefully, the large number of abbreviations in some chapters is not a chaotic alphabet soup.

So many human genetic diseases are now recognized that each has a Mendelian Inheritance in Man (MIM) number (2). Information about these diseases is freely available on the Internet, with links to information about the involved genes and their protein products. To facilitate the reader's access to this material, the Mendelian Inheritance in Man number for specific inherited diseases that are discussed in the book is provided when possible.

Another significant editorial change in the book is the rejection of the possessive form of eponyms for diseases, syndromes, anatomic structures, and other eponymous terms. This was done for multiple reasons, as outlined elsewhere (3), and the trend is gradually gaining momentum in medical writings.

We are fortunate to have been able to enlist the services of some of the most highly qualified investigators in their respective fields who provide authoritative accounts of the current understanding of the enormous spectrum of ocular diseases. To assist us in the critical evaluation of the text and the editing process we also recruited four highly respected ophthalmic pathologists as associate editors (Drs. J. Godfrey Heathcote, J. Douglas Cameron, Victor M. Elner, and Narsing A. Rao). We are most grateful to these individuals, who have expertise in different areas of the subject, for their constructive comments and editorial suggestions. We would also like to acknowledge several other individuals who helped bring this book to fruition: Mr. Geoffrey Greenwood, who convinced us to embark on a third edition, and Ms. Sandra Beberman, Ms. Dana Bigelow, Ms. Beth Campbell, Ms. Mary Drabot, and Mr. Christopher DiBiase of Informa Healthcare, as well as Ms. Paula Garber, Ms. Joanne Jay, and Mr. Peter Compitello of The Egerton Group Ltd., who were most helpful in bringing this book to fruition. As with the previous two editions, we wish to acknowledge the support and encouragement provided by our wives, Felicity and Catherine, and have great pleasure in dedicating this third edition to them.

The preparation of each edition of this book has aptly confirmed the impression of the great British soldier, statesman, author, and first honorary citizen of the United States, Sir Winston Churchill (1874–1965), who stated, "Writing a book is an adventure. To begin with it is a toy, then an amusement. Then it [becomes] a mistress, and then it becomes a master, and then it becomes a tyrant and, in the last stage, just as you are about to be reconciled to your servitude, you kill the monster and fling him to the public" (Grosvenor House, London, November 2, 1949) (4).