AMD
How many people are diagnosed with AMD globally
5%
10%
15%
20%
What ethnicity is AMD most prevalent in
European
South East Asian
African
Latin American
What is NOT a gene associated with inherited AMD
CFH
ARMS2
CFS
True or False : Drusen consists of plasma proteins, immune components, beta amyloid and cholesterol
True
False
A patient presents to clinic and you notice that they have small drusen on their macular and very mild pigmentary changes. How would you grade it using the Beckman Classification?
Early
Intermediate
Geographic Atophy
Neovascular AMD
Rank the risk factors of AMD from the largest to smallest risk of developing AMD
Age
Smoking
Diet
Prolonged exposure to direct sunlight
What are the BIG THREE symptoms of neovascular AMD
Sudden visual distortion
Sudden central blurr
Sudden peripheral vision loss
Sudden vision loss
What is the correct definition of early AMD
Medium sized drusen with mild pigmentary chnanges
Small drusen with no pigmentary changes
Large drusen that is larger than 125um and or pigmentary changes
Medium drusen with no pigmentary changes
What are good tests that can test for AMD
Colour vision
Red Cap
VA in high and low contrast
Amsler grid
Match the definition of: reticular pseudo drusen
Areas of RPE migration that can be seen on top of a druse
Subretinal drusenoid deposits that are yellow in colour and lies between photoreceptors
Shown by signal hyper transmission onto choroid and correlates with attenuation or disruption of the RPE and photoreceptor degeneration
Shown by signal hyper transmission greater than 250um and correlates with attenuation or disruption of the RPE and photoreceptor degeneration
Match the definition of: hyper reflective foci
Areas of RPE migration that can be seen on top of a druse
Subretinal drusenoid deposits that are yellow in colour and lies between photoreceptors
Shown by signal hyper transmission onto choroid and correlates with attenuation or disruption of the RPE and photoreceptor degeneration
Shown by signal hyper transmission greater than 250um and correlates with attenuation or disruption of the RPE and photoreceptor degeneration
Match the definition of: iRORA
Areas of RPE migration that can be seen on top of a druse
Subretinal drusenoid deposits that are yellow in colour and lies between photoreceptors
Shown by signal hyper transmission onto choroid and correlates with attenuation or disruption of the RPE and photoreceptor degeneration
Shown by signal hyper transmission greater than 250um and correlates with attenuation or disruption of the RPE and photoreceptor degeneration
Match the definition of: cRORA
Areas of RPE migration that can be seen on top of a druse
Subretinal drusenoid deposits that are yellow in colour and lies between photoreceptors
Shown by signal hyper transmission onto choroid and correlates with attenuation or disruption of the RPE and photoreceptor degeneration
Shown by signal hyper transmission greater than 250um and correlates with attenuation or disruption of the RPE and photoreceptor degeneration
What percentage of patients with bilateral drusen with pigmentary changes will progress within five years (%)
20%
30%
40%
50%
True or False; the presence of pseudodrusen and drusen together indicates slower rates of progression
True
False
What is NOT an emerging therapy for AMD
Gene therapy
Visual prosthesis
High potenency anti Vegf oral medication
Stem cell therapy
What is the saying for the treatment motto with anti-vegf
Treat and observe
Treat and extend
Treat and preserve
Treat and watch
What is the RANZCO suggestion for review of a patient with GA
Refer as emergency
Monitor 12/12
Monitor 6/12
Refer within 1 week
AMD can only be diagnosed for patients who
Do not have pseudodrusen
Are over 55 years old
Have large drusen and pigmentary changes
Anyone that shows age related pigmentary changes
How can you rule out neovascular AMD from CSR
Age of onset of CSR is most often young
There is often no metaphorpsia or scotoma in CSR
CSR has macular oedema and AMD does not
Have to have OPTHAL second opinion due to drusen in CSR
What are two macular genetic dystrophies that can be a ddx for early AMD
BEST’s disease
Vitiliform macularl dystrophy
Retinitis pigmentosa
Stargardts
What is not a type of Antivegf injections used in Australia to treat AMD
Ranibizumab
Eylea
Avastin
Eyevastumab
True or false: A patient can that had late intermediate AMD that no longer has drusen is in remission
True
False
True or false pseudo drusen is above the RPE
True
False
Advise on nutritional supplements should be given to patients if you…
Notice druplets
Notice any pigmentary changes
When they are diagnosed with intermediate AMD in one eye
They have bilateral early AMD
What is the increased risk of AMD for a smoker compared to a non smoker
2x
4x
6x
8x
A patient presents to you with the complaint of not being able to see well when it is dusk or dawn or when they go from outside to dark room. Based purely on these symptoms and that they do have AMD what would stage based on the Beckmann grading would they have?
Early
Late
GA
Neovascular AMD
Based on this image what is the most likely diagnosis?
Stargardts
Intermediate AMD
Cuticular drusen
Macular telangtasia
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