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AGE-RELATED MACULAR DEGENERATION
Treatment Guideline Chart

Age-related macular degeneration is a common, chronic, progressive, degenerative disease that causes central loss of vision due to abnormalities that occurs in the pigment, neural and vascular layers of the macula.
The macular disorder may have one or more of the following:
- Formation of drusen which are localized deposits of extracellular material usually concentrated in the macula
- Abnormalities in the retinal pigment epithelium (eg hypopigmentation or hyperpigmentation)
- Retinal pigment epithelium and choriocapillaris geographic atrophy                                                                                                                                                                                                            - Neovascular (exudative) maculopathy                                                                                                                                                                                                                                                      - Choroidal neovascularization (CNV), polypoidal choroidal vasculopathy (PCV), reticular pseudodrusen, or retinal angiomatous proliferation

Decreased central vision and distortion of seeing straight lines are the most common symptoms.

Age-related%20macular%20degeneration Patient Education

Patient Education

  • Instruct patients with AMD on how to test their vision daily or at least weekly
    • While patients with exudative AMD or have had laser treatment, should be instructed on how to monitor the size of their blind spots or the appearance of new ones
  • Encourage high risk patients (eg with early AMD and/or family history of AMD) to have regular dilated eye exams for the early detection of the intermediate stage of AMD
    • Patients at very high risk (eg presence of advanced AMD in one eye and large drusen with RPE changes in the fellow eye) should be examined every 6-12 months to detect asymptomatic CNV at a treatable stage
  • For low-risk patients, it is recommended to have comprehensive medical eye evaluation schedule as below:
    • Patients 40-54 years old every 2-4 years
    • Patients 55-64 years old every 1-3 years
    • Patients ≥65 years old every 1-2 years
  • Patients should be informed about the symptoms of progressing CNV (eg progressive decrease in central vision) and counsel on the need for prompt consultation with an ophthalmologist
  • Smoking cessation should be done as this is the main modifiable risk factor for AMD
  • Diet that includes leafy green vegetables, fresh fruits and fishes rich in omega-3 fatty acids may help decrease the risk for AMD
  • Maintain an ideal body weight
    • Increased body mass index (BMI) and abdominal obesity have increased risk for AMD
  • Wear sunglasses with 100% protection against ultraviolet A and B (UVA and UVB) radiation in bright environments
  • Monitor and control blood pressure
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