age related macular degeneration

Question 1

RF for age related macular degeneration

Answer 1

• Age
• smoking
• FH
• CVS rfs

Question 2

classification of age related macular degeneration

Answer 2

dry (atrophic) - most common
* drusen - yellow spots aroiund Bruch’s membrane

wet (exudative or neovascular macular degeneration)
* choroidal neovascularisation
* leakage of serous fluid and blood can -> loss of vision

Question 3

clinical features of ARMD

Answer 3

reduced acuity
* gradual in dry
* subacute in wet

reduced night vision

fluctuations in sx

photopsia - flickering/flashing lights and glare

visual hallucinations - charles bonnet syndrome

Question 4

signs of ARMD

Answer 4

• amsler grid testing - distortion of line perception
• fundoscopy - drusen (yellow) - can become confluent -> macular scar
• wet - demarcated red patch seen - intra-retinal or sub-retinal fluid leakage or haemorrhage

Question 5

ix for ARMD

Answer 5

slit lamp microscopy
* pigmentary, exudative or haemorrhagic changes affecting retina

colour fundus photography

fluorescein angiography if neovascular ARMD suspected - guide anti-VEGF

ocular CT used to visualise retina in 3d

Question 6

treatment of armd

Answer 6

• zinc with anti-oxiant vitamins A C E
• anti-VEGF in wet
• laser photocoagulation in wet but anti-VEGF preferred - risk of acute visual loss