Age Related Macular Degeneration (ARMD) Flashcards
1
Q
Who is affected by ARMD?
A
A degenerative disorder of the macula affecting 50yrs +
2
Q
What is the pathogenesis of ARMD?
A
- Affects central vision but peripheral vision unaffected.
- Photo receptor death
3
Q
What is the pathogenesis of dry ARMD?
A
- accumulation of pigment epithelium waste products (Drusen) and atrophy of retinal pigment epithelium.
- As size of drusen increased vision loss increases
- slowly progressive
4
Q
what does drusen look like on fundoscopy?
A
- yellow fatty deposits under the retina
- mottled atrophic pallor
- reactive hyper-pigmentation
5
Q
What is the pathophysiology of wet ARMD?
A
- accumulation of fluid (oedema)
- secondary neovascularistaion from pigment epithelial disruption.
- can only occur in eye that has dry ARMD
- rapid onset
6
Q
What does wet ARMD look like on fundoscopy?
A
- haemorrhages
- scarring
- swelling (oedematous)
- exudate
7
Q
What are the risk factors for ARMD?
A
- smoking
- age
- family history
- UV exposure
- poor diet
- alcohol
8
Q
What are the symptoms of ARMD?
A
- disturbed CENTRAL vision with blurring, distortion, scotoma.
- difficulty reading fine print
- difficulty recognising faces
- difficulty appreaciating detail.
9
Q
What are the findings on invx of ARMD?
A
- neovascularisation/oedema (wet)
- drusen (dry)
- distorsion/scotoma on AMSLER GRID testing.
- normal pupillary reactions
10
Q
what is scomota?
A
central visual field disturbed
11
Q
what are the differentials for ARMD?
A
- cataracts (can cause blurring)
- retinal detachment (scotoma)
12
Q
What investigation is essential when neovascularisation is suspected in wet ARMD?
A
- fundus fluroscein angiography (FFA)
13
Q
How is dry ARMD managed?
A
- Vitamins (high dose antioxidant vitamins)
- Refraction (visual aids)
14
Q
How is wet ARMD managed?
A
- Photodynamic therapy (PDT)
- laser
- intra-vitreal / antiVEGF agents
15
Q
What is the first line treatment for wet ARMDs?
A
Lucentis (ranibizumab)
