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Posterior Segment > Macular Degeneration > Flashcards

Macular Degeneration Flashcards

1
Q

What’s the size of a large druse?

A

> 125um or the size of a vein coming out of ON head

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2
Q

What’s the percentage of ppl with dry and wet AMD?

A

Dry - 90%

Wet - 10%

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3
Q

What’s the main treatment plan if both eyes have early AMD?

A
  • No AREDs
  • Take Lutein and Zeaxanthin supplements
  • Eat colorful Vegetables
  • No smoking
  • Lose weight/exercise
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4
Q

What VEG-F injection is the best to use? Why?

A

Eyelea

- goes after placental growth factor

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5
Q

What type of inflammation is found in AMD?

A

Complement

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6
Q

What happens to bruch’s membrane while you age? why is this a problem?

A

BM gets thicker; drusen can’t escape = causes RPE detachment

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7
Q

If genetic testing reveals complement factor H, what’s the tx plan?

A

Antioxidant supplements only

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8
Q

Complement system is activated by what?

A

CRP and lipofuscin

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9
Q

What percentage of caucasians express Complement factor H?

A

40%

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10
Q

Which VEG-F isoform is responsible for ocular neovascularization?

A

165

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11
Q

Which genetic factor is responsible for cholesterol metabolism?

A

ABCA1 gene

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12
Q

Which genetic factor is responsible for protection from oxidative stress in mitochondria?

A

ARMS2

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13
Q

Which genetic factor is responsible for breaking down bruch’s membrane to allow drusen to get through?

A

TIMP3

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14
Q

The more ____ that an individual has, the greater risk of AMD.

A

SNPS (Single Nucleotide Polymorphism)

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15
Q

The Beaver Dam Eye Study said what percentage of people aged 75 and older have some form of AMD? What percentage have the advanced form?

A

30%

7%

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16
Q

How many americans are considered “at risk” for developing advanced AMD in the next 5 years?

A

8 million

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17
Q

How many americans are currently affected with the advanced form?

A
  1. 75 million

- will increase to 3 million by 2020

18
Q

What percentage of wet AMD cases have severe vision loss?

A

90%

19
Q

If genetic testing revealed the ARMS2 gene, how would you treat them?

A

Zinc supplements only

20
Q

What ocular findings are associated with dry AMD?

A
  1. Drusen
  2. RPE clumping
  3. RPE Atrophy
21
Q

Early AMD is classified as:

A
  1. > 125um of drusen
  2. Pigmentation
  3. at least 1 intermediate size druse (63-125um)
22
Q

What percentage of early AMD patients will progress to advanced by year 5?

A

1.3%

23
Q

Intermediate AMD is classified as:

A
  1. Inter. Drusen w/in 1/5 of disc area
  2. Large number of druse (>125um)
  3. Non-central GA
24
Q

What percentage of intermediate AMD patients progress to advanced by year 5?

A

18%

25
Q

What’s the tx plan for intermediate AMD?

A

AREDs formula, see them 4x a year

26
Q

Advanced AMD is classified as:

A
  1. CNVM

2. Foveal Geographic Atrophy

27
Q

Will AREDs work for an advanced AMD patient?

A

No, start on injections

28
Q

What’s the average size of a CNVM? How fast does it grow a day?

A 
Ave = 3000-3300um
Growth = 10-20um a day
29
Q

Advanced AMD is associated with what type of death?

A

Cardiovascular death

30
Q

A classic CNVM looks like what? what’s the FA look like?

A

Well-demarcated areas, FA looks defined

31
Q

An occult CNVM will have what type of FA?

A

Slow leak on angiography w/ diffuse ooze

32
Q

80% of eyes w/ CNVM will have what type of vision?

A

worse than 20/40

33
Q

What are the unfavorable prognostic signs leading to CNVM

A
  1. Soft, large drusen
  2. Hyperpigmentation
  3. disciform lesion in fellow eye
  4. Old age
34
Q

AREDS I has beta carotene which is not good for what group of ppl?

A

Smokers

35
Q

does laser photocoagulation of soft drusen stop the progresison of AMD?

A

No, not useful

36
Q

If we want to reduce CRP and IL-6 levels, what medications are suggested?

A

Lipitor
Zocor
Norvir

37
Q

What is the earliest detectable sign of AMD?

A

Drusen

38
Q

The complement cascade system is associated with what 5 factors?

A
  1. Factor H
  2. Factor I
  3. C3
  4. C2
  5. Factor B
39
Q

For the complement factor H gene, tyrosine is replaced with a histidine at position 402 increasing the risk of AMD ~ ___-fold

A

5-fold

40
Q

Genetic testing is great at predicting ____, but weak at predictin ____

A

Great at ARMD

Weak at CNVM

41
Q

If a patient has CFH and ARMS2 alleles, will AREDS work?

A

No

42
Q

Clinical depression is found in what fraction of patients?

A

1/3

Posterior Segment (8 decks)

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