Age related macular degeneration (ARMD)

Question 1

1) What are the 2 types of ARMD?
2) Which of these is the most common?
3) Which of these carry the worse prognosis?

Answer 1

1) Wet and dry
2) Dry
3) Wet

Question 2

Name 2 features of ARMD?

Answer 2

• Drusen (yellow depositis of protein and lipids that can be seen on fundocsopy)
• Atrophy of the retinal pigment epithelium
• Degeneration of the photoreceptors

Question 3

1) In wet AMD there is the development of new vessels growing from the choroid layer into the retina - how can this cause a more rapid loss of vision?
2) What is the key chemical that stimulates the development of these new vessels?

Answer 3

1) Vessels can leak fluid or blood which results in oedema that causes more damage
2) VEGF (vascular endothelial growth factor)

Question 4

Name 2 risk factors for developing ARMD

Answer 4

• Increasing age
• Smoking
• White or Chinese ethnic origin
• Family history
• Cardiovascular disease

Question 5

Name 2 ways ARMD may present

Answer 5

• Gradual worsening central visual field loss
• Reduced visual acuity
• Crooked or wavy appearance to straight lines

Question 6

As well as fundoscopy, name 1 other examination (and what they look for) that might be used in ARMD

Answer 6

• Snellen chart for reduced visual acuity
• Amsler grid test for distortion of straight lines
• Look for scotoma (central patch of vision loss)

Question 7

1) What specific test can be used to diagnose ARMD?
2) What specific test can be used to diagnose wet ARMD?

Answer 7

1) Slit-lamp biomicroscopic fundus examination
2) Optical coherence tomography

Question 8

Anti-VEGF medications are used to treat wet ARMD - name 1 of these drugs

Answer 8

• Ranibizumab
• Bevacizumab
• Pegaptanib