Age-related Macular Degeneration (1) Flashcards
What is this?
What are the 2 types?
What is the Macula made up of?
What is the pathophysiology here?
What occurs in Dry AMD?
What occurs in Wet AMD?
→ What substance is important here? Why’s this relevant?
What are its risk factors?
N.B. Most common cause of Blindness in the UK
➊ Degeneration of the macula that causes progressive deterioration in vision
➋ Wet (10%) and Dry (90%) – Wet type has a worse prognosis
➌ 4 key layers – From bottom to top is the vascular choroid later, Bruch’s membrane, Retinal pigment epithelium, and Photoreceptors
➍ • Atrophy of retinal pigment epithelium
• Degeneration of photoreceptors
➎ • Protein and lipid deposits (Drusen) form in the macula
• Macular thinning that occurs (Geographic atrophy)
➏ There’s neovascularisation from the choroid layer into the retina, which can leak fluid and cause oedema
→ VEGF, so drugs target this
➐ • Age
• Smoking
• CVD
• FHx
How does the vision loss present?
→ How does it differ in Wet AMD?
What else does it present with?
What is a key finding O/E in Dry AMD?
What is a key finding O/E in Wet AMD?
What else is seen O/E?
➊ Gradually worsening central vision loss
→ Much more rapid progression
➋ Crooked/wavy appearance to straight lines
➌ Drusen - Yellow deposits of protein and lipids between the retinal pigment epithelium and Bruch’s membrane
➍ Subretinal/intraretinal haemorrhages
➎ • Reduced visual acuity
• Scotoma – Central patch of vision loss (i.e. enlarged blind spot)
What investigations should be done?
How is Dry AMD managed?
How is Wet AMD managed?
➊ • Fundoscopy
• Optical coherence tomography (OCP) or Fluorescein angiography if Wet AMD is suspected
➋ Lifestyle modifications to slow disease progression e.g. Smoking cessation, BP control
➌ Anti-VEGF medications e.g. Ranibizumab etc. to slow disease progression
