Macular degeneration is a medical condition that usually affects older adults and results in loss of vision in the center of the visual field. It occurs in two forms: dry or geographic macular degeneration, which accounts for 90% of cases and results in atrophy of the retinal pigment epithelial layer; and wet or neovascular macular degeneration, which accounts for 10% of cases and involves abnormal blood vessel growth in the eye. Risk factors include age over 50, heredity, nutrition, smoking, hypertension, sunlight exposure, and cataracts. Treatment depends on the type, with no effective treatment for dry macular degeneration but options like anti-VEGF therapy and photodynamic therapy available for wet

2.  Macular degeneration, often age-related
macular degeneration (AMD or ARMD), is
a medical condition that usually affects older
adults and results in a loss of vision in the
center of the visual field (the macula) because
of damage to the retina.

3.  Age : above 50 yrs - senile macular
degeneration
 bilateral

4.  Non Exudative ARMD-
mild to moderate gradual loss of vision
central shadowing
 Exudative ARMD-
rapidly progressivemarked loss of vision

5.  Degree of hyperfluorescence depends on:
 Extent of overlying RPE atrophy (window
defect)
 Amount of staining
 Lipid content

7.  Heredity
 Nutrition
 Smoking
 Hypertension
 Exposure to sunlight
 Hyperopia
 Blue eyes
 Cataract

8.  Dry or geograhic
 Accounts for 90% ARMD
 atrophy of the retinal pigment epithelial layer
 vision loss through loss of photoreceptors
(rods and cones) in the central part of the eye

9.  Early : 1-Maular drusens-small to
medium sized
2-Focal hyperpigmentation
3-Pale area of RPE atrophy
 Intermediate : 1-drusens-large sized
2-sharply cirumscribed
circular RPE atrophy
 Advanced : 1-Enlarged atrophi areas
2- preexisting drusens disappear
3- visible larger choroidal
vessels

10.  Initial drusen and non-specific RPE changes
 Late RPE (geographic) atrophy

11.  Wet or neovascular type
 Accounts for 10%
 due to abnormal blood vessel growth (choroidal
neovascularization) in the choriocapillaris,
through Bruch's membrane, ultimately leading to
blood and protein leakage below the macula.
 irreversible damage to the photoreceptors and
rapid vision loss if left untreated

12.  Pigment epithelial detachment (PED)
 Choroidal neovascularization (CNV)

13. Circumscribed, dome-shaped elevation Sub-RPE fluid may be clear or turbid

14. Pinkish-yellow subretinal lesion
with fluid
Subretinal blood or lipid

15.  To see Amsler grid
 Snellen chart
 typial signs eluidated on slit-lamp biomicroscopy
 Fundus flurescene angiography
 Iodocyanine angiography
 Optical coherene tomography

16. Hyperfluorescence from RPE window
defect –Atrophic ARMD

17. Early, well-defined
hypofluorescence
Later, thin surrounding
hyperfluorescent ring No increase in size of lesion

18.  No effective treatment
 Measures tried-
1-dietary supplements &
antioxidants
2-smoking cessation
3-Advice amsler grid
regularly
4-low viosion aid

19.  Intraviteral anti-VEGF therapy
Bevacizumab
Ranibiuzumab
Pegaptanib
 Photodynamic therapy-PDT
 Transpupillary thermotherapy
 Double frequeny YAG 532NM
photocoagulation
 Surgical treatment