28 - Age-Related Macular Degeneration Flashcards Preview

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Flashcards in 28 - Age-Related Macular Degeneration Deck (21):
1

Classified as ___ or ___

dry or wet

2

Describe Dry AMD

-drusen (white-yellow spots in central retina)

3

Describe Wet AMD

-responsible for the vast majority of severe vision loss, always occurs in the setting of pre-existing dry AMD
-wet form is caused by presence of a choroidal neovascular memrane (CMV)

4

What are some risk factors for losing vision?

-smoking
-HTN
-family Hx
-light pigmentation of the skin and irides

5

What is the gold standard for investigating AMD

fluorescin angiography

6

Non-pharms?

quit smoking
maintain a balanced diet

7

Pharmacologic Tx:
Describe the VEGFs and how they work (vascular endothelial growth factor inhibitors)

-decrease vision loss in wet AMD, they inhibit growth and cause regression of new blood vessels in CNV membranes

8

Pharmacologic Tx:
How are VEGFs administered?

-injected directly into the vitreous cavity of the eye following application of topical anesthesia and antiseptic eye drops, usually povidone-iodine

9

Pharmacologic Tx:
What are the 4 VEGF examples in Canada?

-ranibizumab (HC approved)
-bevacizumab (off label for wet AMD and also used for colon cancer)
-afilbercept
-pegaptanib (not shown actual improvement in vision so rarely used)

10

Pharmacologic Tx:
How often and for how long do you give VEGFs

-administer every 4 weeks
-most patients require 1 year or more of therapy

11

Pharmacologic Tx:
Example of PDT (photodynamic therapy)

verteporfin

12

Pharmacologic Tx:
How is verteporfin administered?

IV followed by a low level nonthermal laser light

13

Pharmacologic Tx:
s/e of verteporfin (PDT)

-visual disturbances
-will be sensitive to light for 48 hours after

14

Formulas of AREDS containing beta-carotene may increase risk of ____ cancer

lung

15

Lutein 5 mg = _______ 250 mcg

zeaxanthin

16

Take AREDS w food to decrease nausea that may be associated w ____ dose

zinc

17

AREDS causes a ____ reduction of AMD-associated vision loss over 7 years

25%

18

Describe the treatment/recommendation for Dry AMD

-supplement w AREDS
-quit smoking
-self-monitor w Amsler Grid (keep 33cm from face, adequate lighting)

19

Describe the treatment/recommendation for Wet AMD

-supplement w AREDS
-quite smoking
-self-monitor w Amsler Grid (keep 33cm from face, adequate lighting)
-Retinal specialist to consider VEGF inhibitor
-For rare forms of wet AMD - may use verteporfin (PDT)

20

Many patients w AMD also develop _______

depression

21

What would be the reaction with PDT (verteporfin) and tetracyclines?

both cause photosensitivity

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