Internal Medicine

P1: SBT

0521779407-02 CUNY1086/Karliner 0 521 77940 7 June 7, 2007 19:18

Age Related Maculopathy Air Embolus 83

■Follow-Up Guidelines

➣Early AMD and Geographic Atrophy

Complete ophthalmic examination every 6–24 months if no

symptoms, varies on other coexistent ocular morbidities

Daily monitoring of monocular vision by patient using Amsler’s

grid.

➣Late AMD with Exudative Findings after Laser or Photodynamic

Therapy

Visits at 2 to 4, 4 to 6, 6 to 12 weeks, and 3 to 6 months

Thereafter, every 6 months for exam (fluorescein angiography

optional)

Treated patients who report new symptoms may need to be

re-examined before their next scheduled follow-up visit.

Consider retreatment at each visit for reoccurrence of exuda-

tive disease

complications and prognosis

■Complications of progressive exudative disease

➣Exudative RPE and retinal detachment

➣Vitreous hemorrhage

➣RPE tear

➣Disciform scar formation

■Prognosis

➣recurrence rate of approximately 50% after conventional laser

treatment of classic lesions

➣reopening by 4–12 months common after photodynamic therapy

of subfoveal lesions requiring repeat treatment

➣photocoagulation and photodynamic therapy delay severe visual

loss rather than represent a permanent cure in most of cases

AIR EMBOLUS

RAJABRATA SARKAR, MD

history & physical

History

■Most common during operative procedures involving major veins

or cardiopulmonary bypass

■Penetrating trauma to chest (air from lung)

■Insertion or removal of large bore venous lines