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Macular Degeneration, Age-Related

Richard W. Allinson, MD and Francis Allinson, MD Reviewed 06/2020
 


BASICS

DESCRIPTION

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

  • ARMD can be classified as:

    • Atrophic/nonexudative, such as ...

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
Maguire MG, Martin DF, Ying GS, et al; for Comparison of Age-related Macular Degeneration Treatments Trials (CATT) Research Group. Five-year outcomes with anti-vascular endothelial growth ...

CODES

ICD10

  • H35.32 Exudative age-related macular degeneration

  • H35.31 Nonexudative age-related macular degeneration

  • H35.3190 Nonexudative age-related macular degeneration, unspecified eye, stage unspecifi...

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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