Age-Related Macular Degeneration (ARMD) Flashcards
causes
multifactorial increasing age smoking positive FH poor nutrition
two types
- wet
2. dry
define wet ARMD
new blood vessels grow under the retina at the macula which can leak causing build-up of fluid and blood.
this can lead to scarring
presentation of wet ARMD
- rapid central visual loss
- distortion (metamorphopsia)- bends in doorframes, etc.
- sections of vision missing (scotoma/ blind spot)
- difficulty seeing colour
signs of wet ARMD
pale compared to rest of fundus
haemorrhages
fluid can dry leaving exudates
new vessels
diagnosis of wet ARMD
Snellen chart reduced visual acuity
Amsler grid shows distorted lines
OCT scan shows loss of foveal dip due to fluid underneath the macula
fluorescein angiogram to show sub-types of wet
management of wet ARMD
intravitreal injections anti-VEFG e.g. ranibizumab
define dry ARMD
build-up of drusen under RPE which pushes down on the choroid blocking outflow. The retina becomes dysfunctional and atrophic
presentation of dry ARMD
- gradual decline in vision
- central vision missing (scotoma)
signs of dry ARMD
drusen
atrophic patches
orange streaks (choroidal blood vessels)
diagnosis of dry ARMD
ophthalmoscope
OCT
management
no cure
lifestyle e.g. BP, smoking, vitamins
supportive e.g. magnifiers
layers of the macular
choroid layer (bottom)
Bruch’s membrane
RPE
photoreceptors
where does the drusen appear in ARMD
between RPE and Bruch’s membrane
