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Age-Related Macular Degeneration

Michael Ip, MD · Carmen A. Puliafito, MD, MBA

Click on each slide to view a larger image.

	Slide 1A. Fundus photograph of the right eye of a 75-year-old man with neovascular age-related macular degeneration. He presented with decreased vision in his right eye for 4 days. He also complained that straight objects appeared to be curved and "wavy."
	Slide 1B. Fundus photograph of the right eye of a 75-year-old man with neovascular age-related macular degeneration. He presented with decreased vision in his right eye for 4 days. He also complained that straight objects appeared to be curved and "wavy."
	Slide 2A. Fluorescein angiogram of the man with neovascular age-related macular degeneration described in Slide 1.
	Slide 2B. Fluorescein angiogram of the man with neovascular age-related macular degeneration described in Slide 1.
	Slide 3. Shown are large, soft drusen that have poorly demarcated borders. These lesions are age related and reflect diffuse disease of Bruch membrane. Therefore, their presence is a risk factor for the development of neovascular AMD.
	Slide 4. Clinical findings such as focal retinal pigment epithelium (RPE), hyperpigmentation, punctate areas of RPE, hypopigmentation, and geographic atrophy are characteristics of nonneovascular age-related macular degeneration that can lead to vision loss as a result of associated photoreceptor loss.
	Slide 5. The angiogram demonstrated classic choroidal neovascularization, which is characterized by well-demarcated, bright areas of hyperfluorescence.
	Slide 6. Angiogram showing areas of fluorescein leakage with a pattern of speckled hyperfluorescence.
	Slide 7A. Indocyanine green angiography has been used, with variable success, to help better delineate lesion boundaries that are not well-defined on fluorescein angiography.
	Slide 7B. Indocyanine green angiography has been used, with variable success, to help better delineate lesion boundaries that are not well-defined on fluorescein angiography.
	Slide 8. An optical coherence tomography image can distinguish between the various types of retinal pigment epithelium detachments, quantify the extent of retinal thickening, and image choroidal neovascular membranes in the subretinal space.
	Slide 9. This angiogram demonstrates diffuse leakage in the right eye of a patient with age-related macular degeneration.
	Slide 10. This angiogram demonstrates the dramatic decrease in leakage, 1 month following photodynamic therapy.