AGE-RELATED MACULAR DEGENERATION

AGE-RELATED MACULAR DEGENERATION

April 8, 2015 | Andreea Gheorghe, Labib Mahdi, Ovidiu Musat
This study reviews the current understanding of Age-Related Macular Degeneration (AMD), focusing on its pathogenesis, ocular manifestations, diagnosis, and ancillary testing. AMD is a common, chronic, progressive degenerative disorder affecting the macula, leading to central vision loss. It is characterized by the presence of drusen and choroidal neovascularization (CNV) or geographic atrophy. The disease is more prevalent in older individuals, particularly those over 75 years old, and is ranked third as a cause of blindness globally. The risk factors for AMD include personal and environmental factors such as smoking, sunlight exposure, and nutritional factors. The pathogenesis involves the deposition of lipids in Bruch’s membrane, leading to the formation of drusen and subsequent changes in the choroid and retina. Dry AMD, the more common form, is marked by the presence of drusen and geographic atrophy, while wet AMD involves CNV, which can cause severe vision loss. Ocular manifestations of AMD include drusen, geographic atrophy, and CNV. Dry AMD is characterized by drusen and geographic atrophy, while wet AMD involves the growth of new blood vessels under the retina. Clinical examination, along with ancillary tests such as fundus autofluorescence, optical coherence tomography (OCT), fluorescein angiography, and indocyanine green angiography, are essential for diagnosis and monitoring disease progression. OCT is particularly useful for assessing the ultra-structure of drusen and monitoring the progression of AMD. Fundus autofluorescence helps identify areas of geographic atrophy, while fluorescein angiography confirms the presence and characteristics of CNV. Indocyanine green angiography is valuable for diagnosing and guiding treatment, especially in cases of occult or poorly defined CNV. The study emphasizes the importance of early detection and management of AMD to prevent severe vision loss.This study reviews the current understanding of Age-Related Macular Degeneration (AMD), focusing on its pathogenesis, ocular manifestations, diagnosis, and ancillary testing. AMD is a common, chronic, progressive degenerative disorder affecting the macula, leading to central vision loss. It is characterized by the presence of drusen and choroidal neovascularization (CNV) or geographic atrophy. The disease is more prevalent in older individuals, particularly those over 75 years old, and is ranked third as a cause of blindness globally. The risk factors for AMD include personal and environmental factors such as smoking, sunlight exposure, and nutritional factors. The pathogenesis involves the deposition of lipids in Bruch’s membrane, leading to the formation of drusen and subsequent changes in the choroid and retina. Dry AMD, the more common form, is marked by the presence of drusen and geographic atrophy, while wet AMD involves CNV, which can cause severe vision loss. Ocular manifestations of AMD include drusen, geographic atrophy, and CNV. Dry AMD is characterized by drusen and geographic atrophy, while wet AMD involves the growth of new blood vessels under the retina. Clinical examination, along with ancillary tests such as fundus autofluorescence, optical coherence tomography (OCT), fluorescein angiography, and indocyanine green angiography, are essential for diagnosis and monitoring disease progression. OCT is particularly useful for assessing the ultra-structure of drusen and monitoring the progression of AMD. Fundus autofluorescence helps identify areas of geographic atrophy, while fluorescein angiography confirms the presence and characteristics of CNV. Indocyanine green angiography is valuable for diagnosing and guiding treatment, especially in cases of occult or poorly defined CNV. The study emphasizes the importance of early detection and management of AMD to prevent severe vision loss.
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