Age-Related Macular Degeneration

Question 1

Definition

Answer 1

Progressive disease of central retina leading to central visual loss

Question 2

Types

Answer 2

WET AMD

• Choroidal neovascular breaks through to the neural retina
• Leaks fluids, lipids and bloods
• Fibrous scarring
• Develop quickly
• Can treat if caught early

DRY AMD
-Drusen (yellow spots around Bruch’s membrane)

Question 3

Risk Factors

Answer 3

Age > 60
Smoking
FHx
UV exposure
Caucasian
Females

Question 4

Clinical Features

Answer 4

VA —
Central visual loss
Blurring/distortion (Amsler grid)

Question 5

Investigations

Answer 5

1. Fundoscopy - near macular = drusen, pigmentary changes, fluid leaking
2. Optical coherence tomography
3. Fluorescein angiography if neovasculariation

Question 6

Management

Answer 6

CONSERVATIVE
Stop smoking
Beta-carotene, Vit C, E and Zinc

DRY = None

WET =

• Photocoagulation
• Photodynmic therapy
• Anti-vascular endothelial growth factor injection (ranibizumab)