Age related Macular Degeneration

AMD is a acquried degeneration of the retina causing painless loss of central vision usually in elderly persons. AMD is of two types Dry AMD and Wet AMD. Dry AMD causes Geograhic atrophy. Wet AMD causes choroidal neovascular membrane (Sub retinal bleed) .

Symptoms of AMD:

1. Decreased visual acuity, insidious or sudden-onset.
2. Blurred vision
3. Distorted near vision
4. Scotoma
5. Visual distortion, metamorphopsia, micropsia
6. Vague visual complaints

Risk factors age:

1. Age: Risk increases with age. It is more than three- fold in patients older than 75 years age.
2. Cigarette Smoking
3. Genetic susceptibility
4. Cardiovasular disease
5. Hyper tension


Diagnosis: Physical examination. Dilated fundus examination to see for –

1. Drusen
2. Geographic atrophy
3. Subretinal fibrosis
4. RPE changes
5. Subretinal fluid or hemorrhage

Diagnostics procedures:

1. Fundus Fluorescein Angiography /FFA
2. Optical Coherence Tomography /OCT
3. Optical Coherence Tomography Angiography /OCTA
4. Indocyanine Green Anigiograhy /ICG

Management:

1. Medical theraphy: Dry AMD require antioxidant and mineral supplementation
2. Wet AMD: Anti VEGF treatment in the form of intravitrial injection
3. Anti VEGF available are : Bevacizumab (Avastin)
         Ranibizumab (Accentrix)

         Biosimilar Ranibizumab

         Aflibercept (Eylea)

         Brolucizumab (Pagenax)