Age-related macular degeneration (ARMD)
A dry ARMD showing drusen with
areas of RPE atrophy.
Elevated macula with exudate due to
choroidal neovascularization and
pigment epithelium detachment.
Age-related macular degeneration is another popular macular case. You will be expected to know the Macular
Photocoagulation Study and TAP study on photodynamic therapy (which is currently in vogue).
The macula contains drusen. In the non-exudative type there are areas of RPE atrophy. Confluent areas of atrophy
form geographic atrophy (see picture above).
In the exudative (wet) type there may be hard exudates with or without subretinal haemorrhage. The macula may be
elevated due to RPE atrophy. In chronic exudative type, the macula contains fibrosis with RPE atrophy.
Other features to look for:
- examine the opposite eye for similar changes. Age-related macular degeneration is always bilateral. (In younger
patients, consider Doyne's disease or familial inherited drusen or Stargardt's disease).
1. What does the Macular Photocoagulation Study show with regard to age-related macular degeneration?