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Flashcards in Macular Degeneration - Jack Deck (10)
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1

Age-Related Macular Degeneration

  • leading cause of severe central visual acuity loss
  • chronic disease
  • 2 types - Non-Exudative (Dry) and Exudative (Wet)

2

Risk Factors for AMD

age

hyperopia

smoking

low HDL and high LDL

familial history (parents > sibling)

3

Features of Non-Exudative (dry) AMD

drusen

focal hyperpigmentation

retinal pigment epithelieum atrophy

4

Drusen

small or large, round, yellow lesions - between the retinal pigment epithelium basement membrane and Bruch's membrane

5

AERDS Supplementation in AMD

greatest reduction in conversion to advanced AMD
  • lutein/zeaxanthine
    • recommend AREDS 2 over AREDS 1
  • anti-oxidants + zinc + copper
  • zinc + copper alone
  • anti-oxidatnts alone

6

Management of Non-Exduative (Dry) AMD

40-64: 2 year exam

>65: 1-2 year exam

Daily Amsler Grid Monitoring

AREDS 2 Eye Vitamins - Vitamin C, E, Lutein/Zeaxanthine, Zinc, and Copper

Lifestyle modification - smoking cessation, optimize diet, exercise

7

What is being monitored for, using the Amsler Grid?

sudden decreased vision

Metamorphosia: distorted vision in which a grid of straight lines appears wavy 

Sctoma: shadows of missing areas of vision

Blurring

8

Features of Exudative (wet) AMD

chorodial neovascularization

break in Bruch's membrane that allows new blood vessels to grow into the sub-RPE space

the vessels leak fluid, lipid, blood under the RPE and subretinally

can cause subretinal fibrotic scar formation

9

Management of Exudative (Wet) AMD

Anti-VEGF Drugs - Ranibizumab, Aflibercept (+PIGF)

Older therapies that have fallen out of favor: laser photocoagulation, photodynamic therapy

10

Anti-VEGF treatment

recombinant humanzied antibody fragments 

one of the first therapies to stabilize and improve vision: can gain 6-9 letters instead of losing 23 letters