Age-Related Macular Degeneration

Question 1

What is macular degeneration (AMD)?

Answer 1

Degenerative disease of central part of retina (macula)

Commonest cause of sight loss in developed world

Usually >60

Question 2

Clincal features of age-related macular degeneration

Answer 2

Affects reading

Recognising face

Reading text at a distance (e.g. subtitles, bus numbers)

Peripheral vision never affected

Question 3

What is dry macular degeneration?

Answer 3

Gradual loss of retinal cells over many years → slow vision loss

Question 4

What is wet macular degeneration?

Answer 4

Leakage of oedema/blood capillaries from under retina → sudden vision change

Disruption of layers of retina by fluid in wet AMD gives distortion of straight lines

Distortion makes window frames look wavy

Question 5

Risk factors for age-related macular degeneration

Answer 5

Smokng

Question 6

Management of dry macular degeneration

Answer 6

Treatment is supportive (lighting, low vision aids)

Nutritional advice to increase lutein and zeaxanthins in diet (e.g. spinach and kale, or tablets)

Question 7

Management of wet macular degeneration

Answer 7

Urgent referral to eye clinic

Intravitreal anti-VEGF injections (e.g. Eyelea)

Course of repeat injections required

Question 8

Testing wet macular degeneration at home

Answer 8

Amsler chart