Age-Related Macular Degeneration

Question 1

What is age-related macular degeneration (ARMD)?

Answer 1

ARMD is a progressive retinal disorder affecting the macula, leading to central vision loss.

Question 2

What are the two main types of ARMD?

Answer 2

Dry (non-exudative) and Wet (exudative) ARMD.

Question 3

What is the prevalence of ARMD?

Answer 3

It is the leading cause of visual impairment in individuals over 50 in developed countries.

Question 4

What is the macula?

Answer 4

The central part of the retina responsible for detailed central vision.

Question 5

What is the aetiology of ARMD?

Answer 5

A combination of age, genetic factors, and environmental influences such as smoking and diet.

Question 6

What are the main symptoms of ARMD?

Answer 6

Gradual loss of central vision, difficulty reading, and distorted vision (metamorphopsia).

Question 7

What is the pathophysiology of dry ARMD?

Answer 7

Accumulation of drusen (yellow deposits) and atrophy of the retinal pigment epithelium.

Question 8

What is the pathophysiology of wet ARMD?

Answer 8

Growth of abnormal blood vessels under the retina (choroidal neovascularisation), leading to leakage and scarring.

Question 9

What are risk factors for ARMD?

Answer 9

Age, smoking, family history, Caucasian ethnicity, and high-fat diet.

Question 10

What is drusen?

Answer 10

Yellow deposits beneath the retina, often a sign of early dry ARMD.

Question 11

What are clinical signs of ARMD on fundoscopic examination?

Answer 11

Drusen in dry ARMD; subretinal haemorrhage, fluid, or exudates in wet ARMD.

Question 12

What investigations are used to diagnose ARMD?

Answer 12

Fundoscopy, optical coherence tomography (OCT), and fluorescein angiography for wet ARMD.

Question 13

What is the conservative management of dry ARMD?

Answer 13

Lifestyle modifications, such as smoking cessation, UV protection, and a balanced diet with antioxidants.

Question 14

What is the medical management of wet ARMD?

Answer 14

Intravitreal injections of anti-VEGF agents (e.g., ranibizumab, aflibercept).

Question 15

What role does optical coherence tomography (OCT) play in ARMD?

Answer 15

OCT provides detailed imaging of the retina, identifying fluid or drusen associated with ARMD.

Question 16

What are the symptoms of advanced dry ARMD?

Answer 16

Severe central vision loss and difficulty with fine detail tasks, but peripheral vision remains intact.

Question 17

What are the symptoms of wet ARMD?

Answer 17

Rapid central vision loss, distortion (straight lines appear wavy), and scotomas (blind spots).

Question 18

What lifestyle changes can reduce the risk of ARMD progression?

Answer 18

Smoking cessation, maintaining a healthy diet, and taking antioxidant supplements (AREDS formula).

Question 19

What are potential complications of untreated wet ARMD?

Answer 19

Permanent central vision loss due to retinal scarring.

Question 20

What is the role of anti-VEGF therapy in wet ARMD?

Answer 20

It inhibits vascular endothelial growth factor to reduce abnormal blood vessel growth and leakage.

Question 21

What is the difference in progression between dry and wet ARMD?

Answer 21

Dry ARMD progresses slowly, whereas wet ARMD can cause rapid vision loss.

Question 22

What are the differential diagnoses for ARMD?

Answer 22

Diabetic retinopathy, central retinal vein occlusion, and myopic macular degeneration.

Question 23

What is the prognosis for dry ARMD?

Answer 23

Vision loss is gradual and less severe than wet ARMD, but progression to advanced stages is possible.

Question 24

What is the prognosis for wet ARMD?

Answer 24

Without treatment, rapid and severe central vision loss occurs; anti-VEGF therapy can stabilise or improve vision in some cases.

Question 25

Why is early detection of ARMD important?

Answer 25

Early detection allows timely intervention to preserve vision and slow progression.