Macular Degeneration, Age-Related

Richard W Allinson, M.D. and Hunter Grey, Doctor of Optometry Reviewed 05/2023

BASICS

DESCRIPTION

Age-related macular degeneration (AMD) is the leading cause of visual loss in older persons.
Classified as:
- Atrophic/nonexudative, such as drusen or macular pigmentary changes
- Neovascul...

DIAGNOSIS

HISTORY

Patients frequently notice distortion of central vision.

PHYSICAL EXAM

On Amsler grid testing, the horizontal or vertical lines may become broken, distorted, or missing.
Atrophic/nonexu...

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

Patients with soft drusen or pigmentary changes in the macula should monitor their vision, by doing daily Amsler grid testing, and by following ...

REFERENCES

Heier JS, Khanani AM, Quezada Ruiz C, et al. Efficacy, durability, and safety of intravitreal faricimab up to every 16 weeks for neovascular age-related macular degeneration (TENAYA and LU...

ADDITIONAL READING

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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