Age Related Macular Degeneration Flashcards
what is the cause of ARMD?
unknown
what are the risk factors of ARMD?
Unknown
what are the two types of ARMD?
wet and dry
what are the clinical features of
- Difficulty with reading and making out faces
- Difficulty with night vision and changing light conditions – specifically changes in Amsler grid
- Visual fluctuation
- Metamorphosia
what is the 1st part of the development of dry ARMD?
RPE removes and processes the used discs of the photoreceptor outer segments - undigested lipid products, accumulate in the RPE and the excess material is transferred to Bruch’s membrane and extracellular deposits form in the macula
what is the 2nd stage of the development of dry ARMD?
degenerative changes in neighbouring RPE and photoreceptor
what are the clinical features of dry ARMD?
Gradual painless loss of vision
Central vision missing
what are the fundoscopic features of ARMD?
Drusen – yellow lesions
Hypo/Hyperpigmentation patches retina
what is the management of dry ARMD?
- No active treatment
- Supportive – vision aids
- Address underlying risk factors
what are the clinical features of wet AMRD?
- Painless, rapid central visual loss
* Distortion
what will the features of wet AMRD be on fundoscopy?
haemorrhage exudate
what will an OCT scan show in wet AMRD?
fluid in retinal layer – looks like a hill
what is the management of wet AMRD?
- Intravitreal VEGF Inhibitors – bevacizumab, ranibizumab
- Laser Photocoagulation
- Photodynamic therapy - IV verteporfin ops and laser
- Intravitreal steroids – used in adjunct to PDT and VEGF inhibitors
what is a potential consequence of wet AMRD?
retinal detachment
what is the pathophysiology of wet AMRD?
repair dry ARMD, new vessels from the choroid, grow through Bruch’s membrane and the RPE into the sub-retinal space, where they form a sub-retinal neo-vascular membrane.
These are leaky and prone to haemorrhage
