Age related macular degeneratio
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Age-related macular degeneration Definition Macular changes without obvious cause. Characterised by deposition of drusen (small colloid bodies) between retinal pigment epithelium (RPE) and the Bruch's membrane which lines the underlying choroid. Types Early and intermediate age-related macular degeneration (AMD) features drusen deposits with little or no visual symptoms. Can progress to late (aka advanced) AMD, which has 2 forms: Dry (aka atrophic, geographical atrophy): drusen in macula causing progressive atrophy of the RPE. Wet (aka neovascular, exudative): new vessels grow from choroid into retina and leak, causing scarring and possibly detachment. Less common than dry but cause of most visual loss. The term age-related maculopathy is sometimes synonymous with AMD, or refers to pre-clinical stages of disease. Epidemiology Main cause of blindness in UK. UK prevalence: 5% >60 years old, 10% >80.
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Vision loss affects 285 million people worldwide and is caused by conditions like uncorrected refractive errors, cataracts, age-related macular degeneration, diabetic retinopathy, and eye cancer. The major global causes of vision impairment are uncorrected refractive errors, cataracts, and glaucoma which can often be treated, while the major causes of blindness are cataracts, glaucoma, and age-related macular degeneration. Left untreated, common age-related eye diseases like dry and wet macular degeneration, cataracts, and diabetic retinopathy can lead to profound vision loss or blindness.
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Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
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Age related macular degeneratio
- 1. Age-related macular degeneration THIS SLIDE IS MADE WITH THE ASSISTANCE OF MEDICOS PDF APP . HTTPS://BOOKAPP .PAGE.LINK/S LIDESHARE
- 2. Definition Macular changes without obvious cause. Characterised by deposition of drusen (small colloid bodies) between retinal pigment epithelium (RPE) and the Bruch's membrane which lines the underlying choroid. Types Early and intermediate age-related macular degeneration (AMD) features drusen deposits with little or no visual symptoms. Can progress to late (aka advanced) AMD, which has 2 forms:
- 3. Types Dry (aka atrophic, geographical atrophy): drusen in macula causing progressive atrophy of the RPE. Wet (aka neovascular, exudative): new vessels grow from choroid into retina and leak, causing scarring and possibly detachment. Less common than dry but cause of most visual loss. The term age-related maculopathy is sometimes synonymous with AMD, or refers to pre-clinical stages of disease.
- 4. Epidemiology Main cause of blindness in UK. UK prevalence: 5% >60 years old, 10% >80.
- 6. Can be asymptomatic. Symptoms: Distorted vision: straight lines look wavy, micro/macropsia. Loss or blurring of central vision, with black/grey scotoma. In wet AMD, photopsia (flashes) or floaters. Difficulty driving, reading, recognising faces. Usually bilateral, but can be asymmetrical. Rapid symptom progression in wet AMD. Signs: ↓Visual acuity. Fundoscopy: drusen, pigment changes, atrophy, haemorrhages, detachment, scarring (thick yellow patch).
- 7. Risk factors
- 8. Risk factors Age Family history. Smoking Hypertension Obesity
- 9. Investigations Slit-lamp exam: clearer view of fundoscopy findings, and can diagnose early and dry AMD. Optical coherence tomography (OCT) produces a 3D retinal image and can rule out (but not confirm) wet AMD. Fluorescein angiography – a retinal angiogram using IV dye – to confirm wet AMD diagnosis.
- 10. Management
- 11. Advice and support Stop smoking to slow progression. High-dose micronutrients – vitamin C, vitamin E, β- carotene, and zinc – for intermediate or late dry AMD. Ensure any refractive errors are corrected by optician. Help with access to aids like large-print books.
- 12. Advice and support Encourage registration as sight impaired to aid access to benefits. Certificate of Vision Impairment is provided by ophthalmologist, and classified as severe/blind or slight/partially-sited. Advise not to drive and contact DVLA. Usually not allowed to drive if can't read number plate from 20 metres. Specific treatment No specific treatments for dry AMD.
- 13. Wet ARMD: VEGF (vascular endothelial growth factor) inhibitors by intravitreal injection (4-8 weekly): ranibizumab, aflibercept, or bevacizumab (the last being a colorectal cancer drug not licensed for AMD, but equally effective). Photodynamic therapy is an alternative but now not commonly used.
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