Age Related Macular Degeneration

Question 1

What is the most common cause of blindness in the UK

Answer 1

Age related macular defeneration.

Question 2

What is the key feature of age related macular degeneration?

Answer 2

central retina blindness, usually bilaterally.

Question 3

Describe the findings of wet (exudative, neovascular) macular degeneration

Answer 3

• Choroidal neovascularization
• Leakage of serous fluid and blood.
• Worse prognosis - rapid loss of vision.

Question 4

Describe the findings of dry (geographic atrophy) macular degeneration.

Answer 4

• Drusen.

Question 5

What are the risk factors for developing age related macular degeneration?

Answer 5

• Age: most patients are over 60 years of age
• Smoking
• Family history
• More common in Caucasians
• High cumulative sunlight exposure
• Female sex

Question 6

What are the clinical features of age related macular degeneration?

Answer 6

1. Reduced visual acuity: ‘blurred’, ‘distorted’ vision, centrally.
2. Central scotomas
3. Fundoscopy: Drusen, pigmentary changes.

Question 7

What is the general advice, as a GP, to tell patients who have age related macular degeneration.

Answer 7

1. Stop smoking
2. High doses of beta-carotene, vitamins C& E and Zinc help to slow it down.
   
   • NOTE: Supplements should be avoided in smokers due to the increased risk of lung cancer.

Question 8

What are the specialist management options for macular degeration?

Answer 8

1. Dry - nothing
2. Wet

• photocoagulation
• photodynamic therapy
• anti-vascular endothelial growth factor (anti-VEGF) treatments: intravitreal ranibizumab