Age Related Macular Degeneration Flashcards
Two different types of ARMD
Dry or wet
Symptoms of ARMD
Drusen
RPE changes
Degeneration of the photoreceptors
Choroidal neuvascular membrane
Atrophy of retinal pigment epithelium
Central vision loss - failure to read or recognise people
What is wet ARMD
Fluid accumulates in the retina which can be serous or haemorrhage, intraretinal haemorrhage
How common is wet ARMD
10%
What is drusen
Yellow deposits of proteins and lipids that appear between the retinal pigment epithelium and Bruch’s membrane
What is the key chemical which stimulates the development of new vessels
Vascular endothelial growth factor (VEGF)
Risk factors for ARMD
Age, smoking, genetics, CVD, female, caucasian, high cholesterol, obesity, long sightedness, blue eyes
Key eyesight changes in AMD
gradual worsening of central visual field loss, reduced visual acuity, crooked or wavy appearance to straight lines
How is wet AMD worse than dry AMD
Presents more acutely, loss of vision over days, and bilateral disease
Examination of AMD
Reduced acuity using Snellen chart - scotoma is a central patch of vision loss
Amsler grid test to show distorted straight line
Fundoscopy to show drusen
What does an optical coherence tomography do
Gains cross-sectional view of retinal layers used to diagnose AMD
Investigations to diagnose AMD
slit-lamp fundus exam, optical coherence tomography, fluorescein angiography
What does fluorescein angiography do
Contast given and retina is photographed to look in detail at blood supply - shows oedema and neovascularisation
When is fluorescein angiography used
Second line to diagnose wet AMD if optical coherence tomography does not exclude wet AMD
Treatment for dry AMD
No treatment - vitamins, gene therapy studies, anti-inflammatory drugs (slow but not reverse), control BP, avoid smoking
