ARMD

Question 1

What are the potential causes of ARMD?

Answer 1

behavioral/environmental factors e.g. low B12

genetic mechanisms

Question 2

How does ARMD typically present?

Answer 2

In the elderly, with deteriorating central vision

Question 3

What changes can occur at the macula in ARMD?

Answer 3

pigment, drusen (lipid deposits) and bleeding

Question 4

What are the 2 types of ARMD?

Answer 4

dry

wet

Question 5

Which type of ARMD is most common?

Answer 5

dry - 90% cases

Question 6

What are the characteristic features of dry ARMD?

Answer 6

progresses slowly

shows mainly drusen and degenerative changes at the macula

Question 7

What are the characteristic features of wet ARMD?

Answer 7

rapidly deteriorating vision and distortion
occurs when aberrant vessels grown from the choroid into the neuro-sensory retina and leak
ophthalmoscopy shows fluid exudation and localised detachment of the pigment

Question 8

How is wet ARMD treated?

Answer 8

intravitreal VEGF inhibitors
monthly bevacizumab and ranibizumab injections for 1 year
laser photocoagulation
intravitreal steroids

fluorescein angiogram at onset and then every 4-6 weeks with a photograph and OCT

Question 9

How do the intravitreal VEGF inhibitors help in wet ARMD?

Answer 9

increase acuity
decrease cell proliferation
decreased formation of new blood vessels
decreased vascular leaks

Question 10

How can patients self-test their vision once ARMD seen?

Answer 10

“do straight lines on graph paper appear straight”?

refer if distortions or sudden black spots

Question 11

What non-pharacological/non-invasive methods can be used to help vision in ARMD?

Answer 11

visual aids
diet rich in fruit and green leafy veg
supplemented inc, beta-carotene and vits C+E
smoking cessation