Age related macular degeneration

Question 1

what is it?

Answer 1

Degeneration of the central retina (macula) is the key feature with changes usually bilateral.

Question 2

is it bilateral or unilateral

Answer 2

usually bilateral

Question 3

What can be seen via fundosocpy or retinal photography?

Answer 3

formation of drusen

due to degeneration of retinal photoreceptors

Question 4

risk factors

Answer 4

advancing age

smoking

fh

IHD, HTN, Dyslipidaemia and DM

Question 5

2 forms

Answer 5

wet

dryg

Question 6

what are the majority of cases

Answer 6

dry

Question 7

what is dry macular degeneration also known as?

Answer 7

atrophic

Question 8

what is dry macular degeneration characterised as

Answer 8

drusen - yellow round spots in the Bruch’s membrane

Question 9

what is wet macular degeneration also known as?

Answer 9

exudative or neovasulcar macular degeneration

Question 10

what is wet macular denigration characterised by?

Answer 10

choroidal neovascularisation

Question 11

what causes rapid vision loss ins et macular denigration

Answer 11

leakage of serous fluid and blood

Question 12

what carries a worse prognosis - wet or dry?

Answer 12

wet

Question 13

updated classification

Answer 13

early age related macular degeneration

late age related macular degeneration

Question 14

clinical features

Answer 14

reduction in visual acuity

difficulties in dark adaptation

fluctuations in visual disturbance

photopsia - perception of flickering lights

visual hallucinations - resulting in Charles Bonnet syndrome

Question 15

signs

Answer 15

distortion of line of perception - Ampler grid testing

fundoscopy - drusen, macular scar (late sign)

wet - well demarcated red patches - intra-retinal or sub-retinal fluid leakage or haemorrhage

Question 16

Ix

Answer 16

slit lamp microscopy

fluorescing angiography

ocular coherence tomography

Question 17

Mx

Answer 17

zinc with vitamin A,C, E

Vascular endothelial growth factor (VEGF)

laser photocoagulation