Maculopathy & AMD Flashcards
Age-related maculopathy (ARM)
- Definition?
- Characteristics? RPE changes?
- Exaggeration of the ‘normal’ ageing process
-
Characterised by
Drusen
Hyperpigmentation
or depigmentationof the RPE associated with drusen
Age-related macular degeneration (AMD)
- Definition? In relation to ARM?
- Characterised by? (4)
G
P
S
S
- Advanced, sight-threatening stage of ARM
- Characterised by
- Geographic atrophy of the RPE with visible underlying choroidal vessels
- Pigment epithelial detachment (PED)
- Subretinalor sub-RPE choroidal neovascularization (CNV)
- Scar tissue, haemorrhage and exudates
AMD risk factors?
- Age
- ARM
- Race
- Positive family history
- Cataract
- Biomarkers for cardiovascular disease
- Smoking
- Obesity
- Hypertension
Drusen
- What cause it?
- If not cleared, consequence?
- Made up of?
- Effect of Brunch’s membrane?
- Appearance of lesions?
- RPE removes & processes the discs of the outer segments of the photoreceptors
- If not cleared by the RPE, deposits accumulate in Bruch’s membrane
- Made up of lipids
- Bruch’s membrane thickens as a result of the deposits
- Discrete, sub-retinal yellow lesions
Drusen
- Symmetrical?
- Number, size, shape?
- Relationship to age?
- Usually symmetrical in both eyes
- Can vary in number, size, shape etc
- Rarely seen before age 45 years
Increase in size & number with advancing age
Drusen types?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/162/827/608/q_image_thumb.png?1444270939)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/162/827/608/a_image_thumb.png?1444270950)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/162/827/901/q_image_thumb.png?1444270971)
Drusen and AMD
Atrophic AMD
- Other name? Aka?
- Why atrophic?
- Affect what structures?
- Patient present with?
- Affect one or both eye? Symmetrical or not?
- “dry” AMD
- Atrophy which progresses slowly
-
Affects:
Photoreceptors
RPE
Choriocapillaris - Gradual vision impairment. Over months or years
- Affects both eyes (often asymmetrically)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/162/827/998/a_image_thumb.png?1444271254)
Sign?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/162/829/535/q_image_thumb.png?1444271268)
Atropic AMD
Greyish
Can’t really see where macula is
Sign?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/162/829/772/q_image_thumb.png?1444271353)
Atropic AMD
Can see edges of atrophy
If look clearly, can see blood vessels of choroid
Sign?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/162/829/880/q_image_thumb.png?1444271413)
Atrophic AMD
Big scar over macula
Majority of rods and cones ( haemorrhage)
Progress slowly over time.
Jean below
yellowish, atrophic , drusen not obvious, vision affected severely
Sign?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/162/830/152/q_image_thumb.png?1444271526)
Atrophic AMD
Window defect
Brightness of choroidal vessels
Ischaemic area - More profound appearance
Artifarct
RPE detachment
What structure involve? What cause changes?
Pt complant of?
Vision affected?
- Bruch’s membrane thickens up & impedes movement of fluid from RPE to choroid
- Patient c/o Metamorphopsia
- Central vision affected
![](https://s3.amazonaws.com/brainscape-prod/system/cm/162/830/366/a_image_thumb.png?1444271759)
Describe the follow pictures
![](https://s3.amazonaws.com/brainscape-prod/system/cm/162/830/552/q_image_thumb.png?1444271809)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/162/830/552/a_image_thumb.png?1444271828)
RPE detachment
Course?
RPE detachment
- Spontaneous resolution
- Geographic atrophy
- Sensory retinal detachment
- RPE tear