Precise description on Age related normal macular changes, Dry ARMD, GA, Wet ARMD, PCV, RAP

4. DRY/ NON EXUDATIVE/ NON
NEOVASCULAR
WET/ EXUDATIVE/
NEOVASCULAR

7. Drusenoid PED

8. AREDS study

13. • Normal age related changes
Only druplets
Hard,Well defined
• Early ARMD
Medium sized drusen
Well defined
No pigmentary abnormalities

14. • Intermediate ARMD
Large drusen
Soft, Not well demarcated
Pigmentory abnormalities +
Large drusen may coalescence & cause localized RPE elevation (Drusenoid
REP detachment)
Large drusen in BE has risk of progression into late AMD in 13%
If BE large drusen associated with Pigmentary changes, 50%

15. • Late ARMD
• GA (Dry)
• Neovascualar ARMD (Wet)
• CNV
• PED
• Intra/ Subretinal exudates/ h’rrage
• Disciform scar
• VH

23. • Problems
• Max Zn absorbed daily is 25mg
• High Zn dose causes GI problems
• Beta carotine increases the risk of
lung CA is current and Ex smokers
• Beta carotine replaced by Lutein and
Zeaxanthine
Superior to beta carotine in reducing the risk of
advanceARMD
• Reduced Zn dose
• Vit E 400 IU
• Vit C 500 mg
• Lutein 10mg
• Zeaxanthine 2mg
• Zn 25mg
• Cu 2mg

24. Risk factor
points
5 yrs risk % 10 yrs risk %
0 0.5 1
1 3 7
2 12 22
3 25 50
4 50 67

39. • Reduction ofVA > 5
• OCT thickness > 100 microM