Question

Macular Degeneration

1) Five most important objective findings (include most important from PE, labs, x-ray, special tests). Briefly explain why these are the most important findings.

Answer 1

A patient can be assessed for macular degeneration by the following tests:

1. Armsler grid test:

The Amsler grid is a pattern of straight lines that make perfect squares and a dot in the middle. . The patient can look at the grid and notice any areas where the lines look blurry, wavy, or broken. If the grid lines seem to be more distorted than before, it might be a sign that the macular degeneration is getting worse and needs evaluation.

2. Dilated eye exam or Ophthalmoscopy:

In early disease, yellowish subretinal deposits can be seen on the macula. In atrophic disease, areas of depigmentation can be seen on the macula. In the exudative form, fluid can accumulate underneath the retina, as pigment epithelial detachments or subretinal neovascularization

3. Fundoscopy and photography:

The fundus can be examined after dilating the pupil and pictures can be taken. The macular degeneration may reveal findings like, Subretinal fluid, appearing as localized retinal elevation, Retinal edema, Gray-green discoloration under the macula, Exudates in or around the macula, Detachment of retinal pigment epithelium (visible as an area of retinal elevation) and Subretinal hemorrhage in or around the macula.

4. Fluorescein Angiography:

This test is done by injecting the dye to the blood vessels of the eyes and looking for any leakage. Macular degeneration expects the leakage of blood vessels.

5. Optical Coherence Tomography (OCT):

This non invasive test can identify regions of the retina that are thinning, indicating the presence of geographic atrophy, and macular degeneration can be identified.