Gradual loss of vision

Question 1

What is age-related macular degeneration (AMD)?

Answer 1

degeneration of the central retina - macula

Question 2

What are drusen?

Answer 2

yellow deposits under the retina signifying optic nerve head axnal degeneration

Question 3

What are the types of AMD? which is most common?

Which has the worst prognosis

Answer 3

Dry (90%) (early age) - characterised by drusen - yellow round spots in Bruch’s membrane (innermost layer of choroid)
Wet (late age) - choroidal neovascularisation. - leakage of serous fled and blood result in rapid loss of vision - worst prognosis

Question 4

What is the average age of presentation of AMD?

Answer 4

70

Question 5

What are the RFs of AMD?

Answer 5

• Advancing age
• Smoking
• FHx
• CVD - HTN, dyslipidaemia, DM

Question 6

How do patients w AMD tend to present?

Answer 6

Subacute onset of visual loss w:

• Reduced visual acuity
• Poor night vision
• Wavy lines

Question 7

What are the signs of AMD?

Answer 7

• Amsler grid - distortion of line perception

- Fundoscopy - drusen

Question 8

What investigations would u do for AMD?

Answer 8

1. Amsler grid
2. Optical coherence tomography - confirms presence of sub retinal and intraretinal fluid
3. Fluorescein angiography

Question 9

What is the management of dry AMD?

Answer 9

Zinc

Vit A/C/E

Question 10

What is management of wet AMD?

Answer 10

Anti-VEGF agent injections- vascular endothelial growth factor