This document discusses age-related macular degeneration (AMD) and summarizes the findings of the AREDS study. It describes the stages of AMD from early to late dry and wet forms. The AREDS study formulation was modified to address issues like zinc absorption and carotene safety. The revised formula contains lower zinc, vitamins C and E, and lutein/zeaxanthine instead of beta-carotene. A risk scale is provided to estimate 5 and 10-year risks of advanced AMD based on risk factor points.

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