Macular Degeneration

Question 1

What is the commonest cause of blindness in the UK?

Answer 1

Age Related Macular Degeneration. Affects up to 14-25% of >65’s Causes central vision loss

Question 2

What are the 2 types of macular degeneration and which usually comes 1st?

Answer 2

Dry——>Wet

Question 3

Describe the aetiology, signs and symptoms of dry MD?

Answer 3

Atrophy of the retinal pigment epithelial (RPE) due to oxidative damage.

RPE normally protects the photoreceptors by removing the waste products.

Signs and symptoms:

Gradual reduction in central vision (over 2y) clear peripheral vision

Patches of dark pigment

Small drusen (white yellow deposits): these are fibrogranular deposits (waste) accumulating the brush border of the retina.

More common and less severe than wet causes gradual vision loss over years.

Question 4

Describe the aetiology, signs and symptoms of wet MD?

Answer 4

Proliferation of blood vessels from the choroid into subretinal space.

Causes distorted vision and severe fast onset vision loss (2 weeks).

Can also cause retinal/vitreous haemorhage.

Later can cause exudates and fibrosis. (discform scar)

Question 5

What is the treatment for wet MD?

Answer 5

Anti VEGF injections.

Laser photocoagulation

Question 6

Describe what condition can be seen in this image and what features are present?

Answer 6

Dry MD, drusen

Question 7

Describe what condition can be seen in this image and what features are present?

Answer 7

Wet MD

Macula haemorrhage

New blood vessels