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Y3 - Opthalmology > Macular degeneration > Flashcards

Macular degeneration Flashcards

1
Q

What is the most common cause of blindness in the UK?

A

Macular degeneration

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2
Q

What are 2 functions of the macular?

A
  1. Providing central vision
  2. Providing most of our colour vision
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3
Q

What is the diameter of the macular?

A

5mm

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4
Q

What are the 4 layers of the macular from top to bottom?

A
  1. Photoreceptors
  2. retinal pigment epithelium
  3. Bruch’s membrane
  4. Choroid membrane
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5
Q

What does the choroid layer of the retina contain?

A

blood vessels that supply the retina and macular

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6
Q

Describe the general pathophysiology of macular degeneration: (2)

A
  1. with age, there is degeneration of photoreceptors and atrophy of the retinal pigment epithelial layer
  2. Drusen deposits form, affecting vision
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7
Q

What are drusen deposits?

A

yellow deposits of protein and lipids found between the retinal pigment membrane and Bruch’s membrane

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8
Q

What are the two types of macular degeneration?

A
  1. Wet (neovascular)
  2. dry (non-neovascular)
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9
Q

What is wet macular degeneration?

A

where new vessels develop from the choroid layer and grow into the retina and can leak fluid or blood, causing oedema and faster vision loss

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10
Q

What growth factor is largely responsible for the neovascularisation seen in wet macular degeneration?

A

VEGF

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11
Q

What % of macular degeneration cases are wet?

A

10%

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12
Q

What is dry macular degeneration?

A

where no new vessels form, only degeneration of photoreceptors and atrophy of the retinal pigment epithelium layer

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13
Q

Give 6 risk factors for macular degeneration:

A
  1. Increasing age
  2. Obesity
  3. Smoking
  4. CVS such as hypertension
  5. poor diet (low vitamins and high fat)
  6. Family history
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14
Q

True or false: macular degeneration typically has a unilateral presentation

A

True

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15
Q

What are 4 presentations associated with macular degeneration?

A
  1. gradual loss of central vision
  2. reduced visual acuity
  3. Metamorphosia
  4. gradually worsening ability to read small text
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16
Q

What is metamorphosia?

A

where straight lines appear crooked or wavy

17
Q

What presenting complaint is most commonly associated with macular degeneration?

A

gradually worsening ability to read small text

18
Q

Which tends to present more actuely, wet or dry macular degeneration?

A

wet (it can progress to complete vision loss within 2-3 years)

19
Q

Give 4 examinations that may be used to investigate macular degeneration:

A
  1. Snellen chart (for visual acuity)
  2. Scotoma assessment (visual field)
  3. Fundoscopy may show yellow drusen
  4. Amsler grid test
20
Q

What is the Amsler grid test for?

A

metamorphosia

21
Q

What 2 types of imaging is used to view the retina when investigating macular degeneration?

A
  1. optical coherence tomography
  2. Fluorescein angiography
22
Q

What is optical coherence tomography?

A

imaging that allows us to view the layers of the retina and is the primary imaging for diagnosing macular degeneration

23
Q

What is fluorescein agiography?

A

imaging the retina with a fluorescein dye that shows any oedema or neovascularisation associated with wet macular degeneration

24
Q

Give 3 lifestyle changes that can manage risks for those with dry macular degeneration.

A
  1. Avoiding smoking
  2. controlling BP
  3. Vitamin supplementation
25
Q

What class of medications are used to manage wet macular degeneration?

A

anti-VEGF medications (stop the growth of new blood vessels under the retina)

26
Q

Name 3 anti-VEGF drugs used to treat wet macular degeneration?

A
  1. Ranibizumab
  2. aflibercept
  3. Bevacizumab
27
Q

How are anti-VEGF drugs administered into the eye in wet macular degeneration?

A

injected directly into the vitreous chamber once a month

Y3 - Opthalmology (14 decks)

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