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Macular Degeneration, Age-Related

Richard W Allinson, M.D. and Alyce D Alven, MS, OD Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Age-related macular degeneration (AMD) is the leading cause of irreversible, severe visual loss in persons age >65 years.

  • AMD can be classified as:

    • Atrophic/nonexudative, such as dr...

DIAGNOSIS

HISTORY

Patients frequently notice distortion of central vision. On Amsler grid testing, the horizontal or vertical lines may become broken, distorted, or missing. 

PHYSICAL EXAM

  • Atrophic/nonex...

TREATMENT

GENERAL MEASURES

Low-vision aids may be helpful. 

MEDICATION

First Line

  • Ranibizumab (Lucentis)

    • Antibody fragment that inhibits all active forms of VEGF

    • Injected intravitreally, at a dose of 0.5 mg...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Amsler grid can aid in discovering visual disturbances.

  • Patients with soft drusen or pigmentary changes in the macula are at an increased risk of...

REFERENCES

1
Keenan TD, Argon E, Mares J, el al. Adherence to the Mediterranean diet and progression to late age-related macular degeneration in the Age-Related Eye Disease Studies 1 and 2. Ophthalmolo...

ADDITIONAL READING

SEE ALSO

Starr MR, Mahr MA, Barkmeier AJ, et al. Outcomes of cataract surgery in patients with exudative age-related macular degeneration and macular fluid.  ...

CODES

ICD10

  • H35.32 Exudative age-related macular degeneration

  • H35.31 Nonexudative age-related macular degeneration

  • H35.3290 Exudative age-related macular degeneration, unspecified eye, stage unspecified

  • H...

CLINICAL PEARLS

  • Patients may notice straight lines appear crooked (e.g., telephone poles).

  • The ARED Study found that a high-dose regimen of antioxidant vitamins and mineral supplements reduces progress...

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