Nonexudative Age-Related Macular Degeneration



Nonexudative Age-Related Macular Degeneration





SALIENT FEATURES



  • Nonexudative age-related macular degeneration (AMD), otherwise known as “dry AMD,” is associated with the presence of small deposits (ie, drusen), under the macula, and areas of retinal pigment epithelium (RPE) loss and outer retinal atrophy in the more advanced stages.1,4


  • AMD is a leading cause of central vision loss worldwide.4


  • Currently, there is no therapeutic for reversing dry AMD, but results from the AREDS and AREDS 2 clinical trials indicated that increased antioxidant and zinc intake were associated with reduced risk of progression to late-stage AMD.3


  • Late-stage AMD may progress to neovascular AMD (see Chapter 21) and/or atrophy of photoreceptive layers (ie, geographic atrophy [GA]).


  • GA is the concurrent atrophy/loss of the RPE, photoreceptors, and choriocapillaris and can cause significant irreversible vision loss.5


  • Decreased choriocapillaris flow has been associated with progression of dry AMD.4


  • With the advent of optical coherence tomography angiography (OCTA), a new entity has been described: neovascular nonexudative AMD. In these eyes, a choroidal neovascular complex is present on OCTA but is quiescent without any evidence of exudation (eg, intraretinal fluid, subretinal fluid).







FIGURE 21.1 Optical coherence tomography (OCT) for dry age-related macular degeneration (AMD). Drusen results in retinal pigment epithelium (RPE) deflections that may be mild (A) or signficant (B) with associated pigment epithelial detachment and overlying ellipsoid zone (EZ) loss.


OCT IMAGING

May 10, 2021 | Posted by in OPHTHALMOLOGY | Comments Off on Nonexudative Age-Related Macular Degeneration
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