Wet AMD

Question 1

What causes Wet AMD?

Answer 1

Choroidal neovascularization, leading to leaky blood vessels at the macula due to hypoxia or inflammation, resulting in overexpression of VEGF.

Question 2

What are the key signs of Wet AMD?

Answer 2

• Bleed at the macula
• Exudates
• Grey-green lesion at the macula (fibrovascular PED)
• Build-up of fluid
• Disciform scar in late-stage AMD

Question 3

What are the common symptoms of Wet AMD?

Answer 3

• Blurred vision
• Black spot in central vision
• Metamorphopsia (distortion of vision)
• Difficulty reading
• Difficulty recognizing faces

Question 4

What is the urgent management for Wet AMD?

Answer 4

Immediate referral to Hospital Eye Service (HES) for intravitreal injections.

Question 5

What is the first-line treatment for Wet AMD?

Answer 5

Lucentis (ranibizumab), given monthly for 3 consecutive months if there is a loss of more than 5 letters in visual acuity.

Question 6

What is the role of anti-VEGF injections in Wet AMD management?

Answer 6

Anti-VEGF injections help stop the growth of abnormal blood vessels and reduce fluid build-up, given every 4-6 weeks.

Question 7

What is Eyelead (aflibercept) used for in Wet AMD?

Answer 7

It is used after Lucentis, though more injections are often needed.

Question 8

Is Avastin (bevacizumab) licensed for use in Wet AMD treatment?

Answer 8

No, Avastin is not licensed for use in the eye.

Question 9

What is the prognosis for Wet AMD?

Answer 9

• Wet AMD can develop suddenly.
• If treated early, it can be managed, but untreated cases lead to permanent damage and irreversible scarring.

Question 10

What happens if Wet AMD is left untreated?

Answer 10

Blood and leakage will permanently damage retinal nerve cells, eventually leading to irreversible scarring.

Question 11

What is a disciform scar in Wet AMD?

Answer 11

A scar that forms in the macula during the late stage of Wet AMD, leading to permanent vision loss.

Question 12

What is the function of VEGF in Wet AMD?

Answer 12

VEGF (Vascular Endothelial Growth Factor) promotes the growth of abnormal blood vessels in the retina, which leak and cause damage.

Question 13

How often are anti-VEGF injections given in Wet AMD management?

Answer 13

Every 4-6 weeks.

Question 14

What is metamorphopsia in the context of Wet AMD?

Answer 14

A symptom where straight lines appear wavy or distorted.

Question 15

Why is urgent referral crucial in Wet AMD?

Answer 15

Quick intervention is necessary to prevent permanent damage to the retina and to maximize the chance of preserving vision.

Question 16

How does Wet AMD affect central vision?

Answer 16

It can cause a black spot (scotoma) and distortion (metamorphopsia) in the central vision.

Question 17

What is a fibrovascular PED in Wet AMD?

Answer 17

A grey-green lesion at the macula, indicating a pigment epithelial detachment caused by abnormal blood vessel growth.

Question 18

What symptoms indicate advanced Wet AMD?

Answer 18

Difficulty reading, recognizing faces, and presence of a black spot in central vision due to retinal damage.

Question 19

What is the role of Lucentis (ranibizumab) in Wet AMD treatment?

Answer 19

It is the first-line anti-VEGF treatment to prevent further damage and maintain visual acuity.

Question 20

What are the treatment options for Wet AMD if Lucentis is not sufficient?

Answer 20

Eyelead (aflibercept) is used, but it often requires more frequent injections.