“Patience is not passive; on the contrary, it is active; it is concentrated strength.”
- Edward G. Bulwer-Lytton
(English novelist, 1803-1873)

In the subspecialty of retina, one learns early that patience is a necessary attribute. We must exercise patience in many aspects of our daily practice. For our patients, we often must take extra time to explain the nuances of a particular disease and its treatments (and sometimes to rehash that explanation over and over again). In our surgical procedures, we must not rush or risk safety, particularly when faced with a twist in a case that could potentially tack on significant surgical time and difficulty. For those who teach fellows, patience is paramount; after all, let us not forget what it was like the first few times we ventured with our instruments into the murky reaches of the posterior segment.

Patience should not be confused with inertia. Persistence, which breeds innovation, also requires patience. After years of pioneering laboratory research and subsequent clinical evaluations, in this decade retina specialists and their patients finally received the benefits of vascular endothelial growth factor (VEGF) inhibitors. Treatment with these agents now routinely halts, and in some cases reverses, the progression of age-related macular degeneration (AMD). Over the past 2 years, new medical options for our patients with retinal vein occlusions have also been introduced.

Still, we await new therapies for a range of retinal diseases. This issue of Retina Today focuses on therapies in the research and development pipeline for posterior segment diseases. These include, most notably, diabetic macular edema, for which new treatments are very close on the horizon. We also await efficacious therapies for geographic atrophy in dry AMD, for which there is still no approved pharmacologic treatment, despite our success against the exudative form of the disease. We also look forward to therapies for wet AMD that can be used in combination with anti- VEGF agents to reduce the burden of frequent injections on patients and practices alike.

We know potentially effective therapies for these and other posterior segment pathologies are in the pipeline, so we must be patient. Remember that good things come to those who wait. But also remember that patience is not passive, and we must endeavor in the meantime to care for our patients the best we can with the tools we currently have available.