Age-Related Macular Degeneration
Overview
Age-related macular degeneration (ARMD) refers to an acquired degeneration of the retina with characteristic findings of drusen (yellow protein and lipid-rich extracellular deposits), retinal pigment abnormalities, and retinal atrophy (geographic atrophy).
If choroid neovascular membrane formation is present ("leaky capillaries") then the disease is referred to as “wet” or exudative or neovascular.
The majority of ARMD, however, is "dry" or nonexudative or nonneovascular disease -- there is no neovascularization.
Risk Factors
- Age
- White race (European descent)
- Family history
- Light irides
- Female gender
- Atherosclerotic risk factors
- tobacco abuse, hypertension, hypercholesterolemia, obesity
Clinical Presentation
We might assume central visual acuity would be a reliable indicator of disease severity but, in fact, central visual acuity may be preserved early in the disease and poorly correlates with disease severity.
Although visual acuity is often gradually affected, a worrisome reality is that visual acuity can be suddenly affected in this disorder.
Patients complain usually complain of blurred or distorted vision, or ill-defined abnormalities.
Diagnosis
Diagnosis is confirmed using fluorescein angiography and optical coherence tomography (OCT).
See classic choroidal neovascular membrane in age-related macular degeneration via:
Clinical Management
Clinical management involves risk factor modification, antioxidant and mineral supplementation, complement factor inhibition (eg, pegcetacoplan and avacincaptad pegol) and anti-VEGF treatment for wet macular degeneration.
Image Reference
Age-Related Macular Degeneration