Macular degeneration Flashcards
What is macular degeneration?
Degeneration of the central retina (macula)
What are the risk factors for macular degeneration?
Advancing age
Smoking
Family history
Female
Cardiovascular disease
Obesity
What is the presentation of macular degeneration?
Gradual loss of central vision
Reduced visual acuity
Crooked or wavy appearance to straight lines
Difficulties in dark adaptation
Photopsia - perception of flickering or flashing lights
What are the types of macular degeneration?
Dry macular degeneration - most common, characteristed by drusen
Wet macular degeneration - characterised by neovascularisation of the choroid
What are drusen?
Drusen are yellow deposits of proteins and lipids between the retinal pigment epithelium and Bruch’s membrane
What are the layers of the macula?
Choroid layer (at base)
Bruch’s membrane
Retinal pigment epithelium
Photoreceptors (towards surface)
What is the macula?
The macula is the central area of the retina, which generates high definition colour vision
What is the pathophysiology of wet macular degeneration?
New vessels develop from the choroid layer and grow into the retina.
If the vessels leak fluid or blood, this can cause oedema and vision loss
What examination findings are associated with macular degeneration?
Reduced visual acuity
Scotoma (enlarged central area of vision loss)
Amsler grid test (to test for distortion of straight lines)
Drusen seen on fundoscopy
What is the initial investigation of choice in macular degeneration?
Slit lamp testing
What is the management of dry macular degeneration?
No specific treatment
- Avoiding smoking
- Controlling blood pressure
- Vitamin supplementationW
What is the treatment of wet macular degeneration?
Anti-VEGF medication (vascular endothelial growth factor), to prevent development of new blood vessels in the retina
