P1: SBT
0521779407-02 CUNY1086/Karliner 0 521 77940 7 June 7, 2007 19:18
82 Age Related Maculopathy■Diagnosis of Age Related Maculopathy is established by funduscopic
examination and fluorescein angiography
■Treatment dictated by type of disease: early or late, and by subtype
of choroidal neovascularization
specific therapy
■Early AMD
➣Observation
■Later AMD
➣Geographic atrophy (of the RPE)
➣Observation
■Choroidal neovascularization & related complications (i.e. hemor-
rhage, RPE detachment)
■“classic” juxtafoveal and extrafoveal CNV
➣conventional laser photocoagulation
■subfoveal and/or occult CNV
➣photodynamic therapy
whereby a photosensitive dye is injected into a peripheral vein
and activated with laser light
once it reaches the neovascular complex, reactive free radicals
are produced that selectively occluding the leaking new vessels
■Side effects/complications of laser photocoagulation.
➣Loss of visual acuity acutely with the understanding that in the
long term more is preserved
➣Epiretinal membrane formation
■Investigational Approaches
➣Subretinal Surgery
➣Macular Translocation
➣Radiation Treatment
➣Pharmacologic Therapies
follow-up
■based on extent of AMD and treatment
■The follow-up history should take into account the following:
➣Symptoms
➣Changes in medication
➣Changes in medical and ocular history
➣Changes in family history & social history
■The follow up examination visit should include the following.
➣Assessment of best corrected visual acuity
➣Vision testing with an Amsler’s grid
➣Biomicroscopic examination of macula