Term
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Definition
deterioration of macula resulting in loss of central vision & high-resolution visual acuity;
leading cause of severe, irreversible vision impairment |
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Term
| Definitive Risk Factors for Macular Degeneration |
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Definition
age;
light pigmentation (white ethnicity);
cigaretter smoking;
family history |
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Term
| Potential Risk Factors for Macular Degeneration |
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Definition
| cardiovascular dx, HTN, low dietary intake of antioxidant vitamins or Zn, increased BMI, high dietary fat intake |
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Term
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Definition
formation of drusen;
retinal pigment abnormalities: atrophy of retinal pigment epithelium or pigmentary clumping; |
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Term
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Definition
advanced, worse prognosis;
neovasularization in macula: abnormal growth of blood vessels in subretinal space, vessels leak --> subretinal fluid &/or bleeding beneath the retina |
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Term
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Definition
small or intermediate drusen & minimal macular pigment abnormalities;
usually normal central vision |
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Term
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Definition
medium or large drusen in 1 or both eyes;
18% of pts will progress to advaned w/in 5 yrs |
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Term
| Non-neovascular Advanced (Dry) AMD |
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Definition
| atrophy of retina & other layers of macula |
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Term
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Definition
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Term
| Symptoms of Macular Degeneration |
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Definition
mild blurry central vision;
difficulty reading;
trouble w/ color & contrast;
painless, progressive, moderate to severe blurring of central vision;
sudden loss or distortion of vision possible |
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Term
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Definition
drusen visible on dilated exam;
patches on geographic atrophy or increased pigmentation;
subretinal fluid and/or hemorrhage in wet AMD |
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Term
| Treatment Goals for Macular Degeneration |
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Definition
slow disease progression;
maintain QOL;
minimize adverse effects |
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Term
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Definition
| no approved pharmacologic therapy for this type of AMD |
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Term
| Antioxidant supplementation - ascorbic acid 500 mg, vitamin E 400 IU, beta-carotene 15 mg, zinc oxide 80 mg, cupric oxide 2 mg |
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Definition
used in Age-Related Eye Disease Study;
reduced rate of clinical progression of all types of AMD by 28% in pts w/ intermediate AMD;
recommended in pts w/ |
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Term
| Vascular Endothelial Growth Factor (VEGF) Antagonists - pegaptanib (Macugen), ranizumab (Lucentis), bevacizumab (Avastin) |
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Definition
MoA: binds to growth factors to suppress neovascularization;
Dose: prefilled intravitreal injections once monthly;
Side Effects:
Local - inflammation, blurred vision, conjunctival hemorrhage, pain, vitreous floaters;
Systemic - HTN, HA, possible increase in stroke;
C/Is: ocular infection; |
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Term
| Non-Pharm Treatment for Dry AMD |
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Definition
stop smoking;
laser drusen ablation - role is unclear |
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Term
| Non-Pharm Treatment of Wet AMD |
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Definition
Thermal laser photooagulation - high intensity laser coagulates abnormal choroidal neovascular membranes;
Photodynamic therapy - locally damages neovascular endothelium, reduces risk of visual acuity loss & legal blindness over 1-2 yrs, requires multiple treatments, SE: severe photosensitivity;
Surgery & radiation -> significant risks, little to no benefit |
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