Age Related Macular Degeneration Flashcards
classify age related macular degeneration (ARMD)
- wet - neovascular
- dry - non-neovascular
what is ARMD?
age-related deterioration in the macula leading to the reduction in central vision
what is the macula?
the central area of the retina
what are the risk factors of ARMD?
- age
- smoking
- females
- ethnic origin - white
- dietary factors
- CV risk
- long-sighted
describe dry ARMD
gradual but reduces central vision
affects 90% of ARMD
what are the clinical features of dry ARMD
- Drusen
- PAS-positive amorphous deposite between RPE basement membrane and inner collagenous layer of Bruch’s membrane
- RPE changes
- Focal hyperpigmentation (clumps of pigment cells)
- Geographic atrophy (advanced / later stages)
- Loss of RPE
- Loss of photoreceptors
- Basement membrane deposit (basal linear deposit)
- Between RPE basement membrane and RPE cells
what are the symptoms of dry ARMD?
- decreased central vision
- distortion
what is the treatment of dry ARMD?
- Support - counselling/visual aid
- refract
- amsler grid
- lifestyle changes - diet/smoking
- vitamin supplements
what vitamin supplements are given in dry ARMD?
- 500 milligrams (mg) of vitamin C
- 400 international units (equivalent to about 270mg) of vitamin E
- 10 mg lutein
- 2 mg zeaxanthin
- 25 mg or 80 mg zinc as zinc oxide (as recommended by your
doctor) - 2 mg copper as cupric oxide
describe wet ARMD
rapid, severe loss of vision
less common
what is the pathology of wet ARMD
- new capillaries through the bruchs membrane
- proliferation beneath RPE/retina
- other e.g. haemorrhage/leakage/scarring
what are the clinical features of wet ARMD
- decreased vision
- distortion and missing patches
- grey membrane on examination
- haemorrhage
- fluid
- subretinal fibrosis
what does OCT detect?
investigating/monitoring …
subretinal fluid
intraretinal fluid
pigment epithelial detachment
fibrosis/scarring
what does fundus fluorescin angiogram detect?
fluorscent dye injected intravenously - absorbing blue light and emitting yellow/green lights
image of circulating in the eye
what is the treatment of wet ARMD?
- support - counselling/visual aids
- intravitreal anti-VEGF therapy
- photodynamic therapy