Age-Related Macular Degeneration
Progressive degeneration of the macula in elderly patients.
Age-related macular degeneration is the most frequent causeof blindness beyond the age of 65 years.
Drusen develop in the retinal pigment epithelium due toaccumulation of metabolic products.
Patients notice agradualloss of visual acuity. Where macularedema is present, patients complain of image distortion (metamorphopsia), macropsia, or micropsia.
Ophthalmoscopic examinationcan distinguish two separate stages that occur in chronological order (Table 12.6).
Other vascular diseases of the retina such as branchretinal vein occlusion should be excluded by ophthalmoscopy. Malignant melanoma should be excluded by ultrasound studies.
No reliably effective medical therapy is available. Laser therapymay be performed in the exudative stage in about 5 â€“ 10% of all patients without neovascularization involving the fovea centralis. Use of progressively stronger near vision aids such as a hand magnifier or binocular magnifier should be tried.
The course of the disorder is chronic andleads to progressive loss of visual acuity.
Laser therapy may be performed in the exudative stage of late age-related macular degeneration in 10% of all patients provided the dis-order is diagnosed early.