Age-related macular degeneration

Question 1

What is the most common cause of blindness in the UK?

Answer 1

Age-related macular degeneration (ARMD)

ARMD is characterized by degeneration of the central retina (macula) and affects vision.

Question 2

What are the key features of age-related macular degeneration?

Answer 2

Degeneration of retinal photoreceptors and formation of drusen

Drusen can be seen on fundoscopy and retinal photography.

Question 3

What is the greatest risk factor for ARMD?

Answer 3

Advancing age

The risk increases significantly for patients over 75 years.

Question 4

How much does the risk of ARMD increase for patients older than 75 years compared to those aged 65-74?

Answer 4

3 fold increase

Question 5

True or False: Current smokers are less likely to have ARMD-related visual loss compared to non-smokers.

Answer 5

False

Current smokers are twice as likely to have ARMD-related visual loss.

Question 6

What is the increased risk for first-degree relatives of ARMD sufferers?

Answer 6

Four times more likely to inherit the condition

Question 7

List other risk factors for developing ARMD.

Answer 7

• Hypertension
• Dyslipidaemia
• Diabetes mellitus

Question 8

What are the two traditional forms of macular degeneration?

Answer 8

• Dry macular degeneration
• Wet macular degeneration

Question 9

What percentage of ARMD cases are classified as dry macular degeneration?

Answer 9

90%

Question 10

What is another name for dry macular degeneration?

Answer 10

Atrophic macular degeneration

Question 11

What characterizes wet macular degeneration?

Answer 11

Choroidal neovascularisation and leakage of serous fluid and blood

Wet macular degeneration accounts for 10% of cases and carries the worst prognosis.

Question 12

What are the clinical features of ARMD?

Answer 12

• Reduction in visual acuity
• Difficulties in dark adaptation
• Fluctuations in visual disturbance
• Photopsia
• Visual hallucinations

Question 13

What is the initial investigation of choice for ARMD?

Answer 13

Slit-lamp microscopy

This is often accompanied by colour fundus photography.

Question 14

What is fluorescein angiography used for in ARMD?

Answer 14

To guide intervention with anti-VEGF therapy if neovascular ARMD is suspected

Question 15

What is the role of vascular endothelial growth factor (VEGF) in wet ARMD?

Answer 15

Drives increased vascular permeability

Question 16

What should be instituted within the first two months of diagnosis of wet ARMD?

Answer 16

Anti-VEGF therapy

Question 17

Name examples of anti-VEGF agents.

Answer 17

• Ranibizumab
• Bevacizumab
• Pegaptanib

Question 18

What is the risk associated with laser photocoagulation treatment for ARMD?

Answer 18

Acute visual loss after treatment

Question 19

Fill in the blank: The two forms of late age-related macular degeneration are _______ and _______.

Answer 19

[neovascularisation], [exudative]