Posterior Segment
Age-Related Macular Degeneration
Also known as: AMD, ARMD, age-related macular degeneration, dry AMD, wet AMD, neovascular AMD, geographic atrophy, drusen
Filed as: Urgent
Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed
Clinical decision support only
Overview
Progressive degeneration of the macula in older adults. Beckman classification: early (medium drusen ≥63 and <125 μm with NO pigmentary abnormalities), intermediate (large drusen ≥125 μm and/or ANY AMD pigmentary abnormality), late (geographic atrophy or neovascular). Neovascular AMD is treatable with anti-VEGF; referral timing determines visual outcome. Optometrists detect, stage, monitor, and refer; treatment is specialist-initiated.
Recognition
Symptoms: what patients report
- Asymptomatic in early disease — screening detects drusen.
- Gradual central blur — geographic atrophy (dry).
- Rapid central distortion or loss — wet AMD; days to weeks.
- Metamorphopsia — straight lines appear wavy; Amsler grid positive.
- Central scotoma — patch of missing vision.
Signs: what the examination shows
- Drusen — yellow deposits; hard (small, distinct) or soft (larger, ill-defined).
- Pigmentary changes — RPE hyperpigmentation or hypopigmentation.
- Geographic atrophy — sharply demarcated areas of RPE and choriocapillaris loss; pale with visible choroidal vessels.
- Neovascular AMD: subretinal fluid, haemorrhage, pigment epithelial detachment, subretinal fibrosis.
- Disciform scar — end-stage wet AMD.
What OptoGuide™ covers for age-related macular degeneration
- Pattern reasoning: what this combination of findings points to, and its differentiators
- Don't-miss risks and escalation triggers
- Management tiers with linked Australian therapeutics
- Referral urgency, specialty, and letter drafting
Sources
- Age-Related Macular Degeneration PPP — AAO
- Age-Related Macular Degeneration — EyeWiki
- Current Perspective on Age-Related Macular Degeneration. Chakravarthy U, Peto T. JAMA. 2020;324(8):794-795.
- Real-world use of ranibizumab for neovascular age-related macular degeneration in Taiwan. Chang YS, Lee WJ, Lim CC, et al. Scientific Reports. 2018;8(1):7486.
- Sensitivity and Specificity of Potential Diagnostic Features Detected Using Fundus Photography, Optical Coherence Tomography, and Fluorescein Angiography for Polypoidal Choroidal Vasculopathy. Chaikitmongkol V, Kong J, K
Standard texts: Kanski's Clinical Ophthalmology: A Systematic Approach, The Wills Eye Manual, Oxford Handbook of Ophthalmology, Oxford American Handbook of Ophthalmology, Signs in Ophthalmology: Causes & Differential Diagnosis.