Age Related Macular Degeneration

Question 1

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

Answer 1

Age related macular degeneration

Question 2

What is age related macular degeneration?

Answer 2

Degeneration is the central retina (the macula)- usually bilateral

It is characterised by degeneration of retinal photoreceptors that results in formation of drusen.

Question 3

What are the 2 types of age related macular degeneration?

Answer 3

Dry macular degeneration (90%of cases)- characterised by drusen- yellow round spots
Presents earlier

Wet macular degeneration (10%)- characterised by choroid all neovascularisation, exudative. Leakage of serious fluid and blood can result in rapid loss of vision
Carries worst prognosis

Question 4

Name some RF for age related macular degeneration

Answer 4

Advancing age
Smoking
FHx
CVD e.g HTN, dyslipidaemia and DM

Question 5

How do patients with age related macular degeneration usually present?

Answer 5

Sub acute visual loss
Reduction in visual acuity particularly near field objects
Difficulties in dark adaptation with an overall deterioration in vision at night
May have photopsia

Question 6

What signs would you expect in age related macular degeneration?

Answer 6

Distortion of line perception on Amsler grid testing

Drusen on fundoscopy in Dry
Well demarcated red patches indicating intra-retinal or sub-retinal fluid leakage or haemorrhage in Wet.

Question 7

Name 3 investigations useful in age related macular degeneration

Answer 7

Slit-lamp microscopy
Fluorescein angiography
Ocular coherence tomography
Fundoscopy