Age-Related Macular Degeneration Classification
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Questions and Answers

Which type of AMD is characterized by geographic atrophy in the absence of neovascular AMD?

  • Early AMD
  • Late AMD (wet inactive)
  • Late AMD (dry) (correct)
  • Late AMD (wet active)

    • What is the recommended time frame for referring people with suspected late AMD (wet active) to a macula service?

  • As soon as possible, but no specific time frame
  • Within 1 working day (correct)
  • Within 14 working days
  • Within 7 working days

    • What is the recommended test to confirm a diagnosis of late AMD (dry)?

  • Slit-lamp biomicroscopic fundus examination (correct)
  • Visual Acuity Test
  • Fundus Fluorescein Angiography (FFA)
  • Optical Coherence Tomography (OCT)

    • What is the recommended treatment for eyes with confirmed late AMD (wet active) if the visual acuity is 6/96 or worse?

    <p>Anti-VEGF treatment only if the affected eye is the person's better-seeing eye</p> Signup and view all the answers

    Which of the following is NOT a risk factor for AMD?

    <p>Diet high in fruits and vegetables</p> Signup and view all the answers

    What is the recommended test to offer people with suspected late AMD (wet active) if clinical examination and OCT exclude neovascularisation?

    <p>No further testing is required</p> Signup and view all the answers

    What is the recommended time frame for offering treatment to eyes with confirmed late AMD (wet active)?

    <p>Within 14 days of referral to the macular service</p> Signup and view all the answers

    Which type of AMD is characterized by classic choroidal neovascularisation (CNV)?

    <p>Late AMD (wet active)</p> Signup and view all the answers

    What is the recommended action for people with asymptomatic early AMD?

    <p>Offer fundus examination as part of the ocular examination</p> Signup and view all the answers

    What is the characteristic of an eye classified as 'Normal' under the age-related macular degeneration classification?

    <p>No signs of age-related macular degeneration with only small 'hard' drusen</p> Signup and view all the answers

    Which of the following is a characteristic feature of Late AMD (wet inactive)?

    <p>Fibrous scar</p> Signup and view all the answers

    According to the AMD classification, what is the size of medium drusen?

    <p>63 micrometres or more and less than 125 micrometres</p> Signup and view all the answers

    What is the characteristic of an eye classified as 'Early AMD' with high risk of progression?

    <p>Presence of reticular drusen with pigmentary abnormalities</p> Signup and view all the answers

    What is the characteristic of an eye classified as 'Late AMD'?

    <p>Presence of retinal pigment epithelial degeneration with subretinal fluid</p> Signup and view all the answers

    What is the characteristic of an eye classified as 'Early AMD' with low risk of progression?

    <p>Presence of medium drusen only</p> Signup and view all the answers

    What is the characteristic of an eye classified as 'Late AMD' with retinal pigment epithelial degeneration?

    <p>Presence of subretinal or intraretinal fluid in the absence of neovascularisation</p> Signup and view all the answers

    What is the primary difference between an eye classified as 'Early AMD' with medium risk of progression and an eye classified as 'Early AMD' with high risk of progression?

    <p>Presence of pigmentary abnormalities</p> Signup and view all the answers

    What is the minimum size of drusen required for an eye to be classified as 'Early AMD' with medium risk of progression?

    <p>125 micrometres</p> Signup and view all the answers

    What is the characteristic feature of an eye classified as 'Late AMD' that is not related to neovascularisation?

    <p>RPE degeneration and dysfunction</p> Signup and view all the answers

    What is the characteristic feature of an eye classified as 'Normal' under the age-related macular degeneration classification?

    <p>Absence of any signs of AMD</p> Signup and view all the answers

    What is the primary characteristic of an eye classified as 'Early AMD'?

    <p>Presence of medium drusen or pigmentary abnormalities</p> Signup and view all the answers

    What is the size range of drusen that defines an eye classified as 'Early AMD' with low risk of progression?

    <p>63 micrometres or more and less than 125 micrometres</p> Signup and view all the answers

    What is the primary purpose of referring people with late AMD (dry) to hospital eye services?

    <p>To certify sight impairment or access low-vision services</p> Signup and view all the answers

    What is the recommended course of action if OCT does not exclude neovascular disease in people with suspected late AMD (wet active)?

    <p>Offer fundus fluorescein angiography (FFA) to confirm the diagnosis</p> Signup and view all the answers

    Which of the following risk factors is not associated with an increased likelihood of developing AMD?

    <p>Diet high in omega-3 and 6</p> Signup and view all the answers

    What is the recommended time frame for offering treatment to eyes with confirmed late AMD (wet active)?

    <p>Within 14 days</p> Signup and view all the answers

    What is the primary purpose of fundus examination in people presenting with changes in vision?

    <p>To rule out other ocular conditions</p> Signup and view all the answers

    What is the recommended action for people with asymptomatic early AMD?

    <p>Monitor them for signs of progression</p> Signup and view all the answers

    What is the characteristic feature of Late AMD (wet active) that distinguishes it from Late AMD (dry)?

    <p>Presence of neovascularisation</p> Signup and view all the answers

    When is it recommended to consider anti-VEGF treatment for eyes with late AMD (wet active)?

    <p>When visual acuity is 6/96 or worse</p> Signup and view all the answers

    What is the primary purpose of slit-lamp biomicroscopic fundus examination in people with suspected AMD?

    <p>To confirm a diagnosis of early AMD</p> Signup and view all the answers

    What is the recommended action for people with late AMD (wet active) who have a visual acuity of 6/96 or worse?

    <p>Offer anti-VEGF treatment only if the affected eye is the better-seeing eye</p> Signup and view all the answers

    Study Notes

    • AMD classification is based on the presence of specific signs and symptoms.
    • Normal eyes have no signs of AMD, with small 'hard' drusen (less than 63 micrometres) only.
    • Early AMD has low, medium, or high risk of progression, defined by drusen size, pigmentary abnormalities, and reticular drusen.
    • Late AMD is classified into three subcategories: indeterminate, wet active, and dry.
    • Late AMD (indeterminate) is characterized by retinal pigment epithelial (RPE) degeneration and dysfunction.
    • Late AMD (wet active) is defined by the presence of choroidal neovascularisation (CNV), occult or mixed CNV, retinal angiomatous proliferation (RAP), and polypoidal choroidal vasculopathy (PCV).
    • Late AMD (dry) is characterized by geographic atrophy, dense or confluent drusen, advanced pigmentary changes, and/or atrophy.

    Risk Factors for AMD

    • Older age is a risk factor for AMD.
    • Presence of AMD in the other eye increases the likelihood of AMD.
    • Family history of AMD is a risk factor.
    • Smoking, hypertension, and high BMI (≥ 30 kg/m²) are risk factors for AMD.
    • Diet low in omega 3 and 6, vitamins, carotenoids, and minerals, and high in fat, increases the risk of AMD.
    • Lack of exercise is a risk factor for AMD.

    Diagnosis and Referral

    • Fundus examination is recommended for people presenting with changes in vision or visual disturbances.
    • Early AMD diagnosis is confirmed using slit-lamp biomicroscopic fundus examination.
    • People with asymptomatic early AMD should not be referred to hospital eye services for further diagnostic tests.
    • Late AMD (dry) diagnosis is confirmed using slit-lamp biomicroscopic fundus examination.
    • Referral to hospital eye services is recommended for people with late AMD (dry) only for certification of sight impairment, access to low-vision services, or if new visual symptoms suggest late AMD (wet active).
    • Urgent referral to a macula service is recommended for people with suspected late AMD (wet active).
    • Optical coherence tomography (OCT) is recommended for people with suspected late AMD (wet active).
    • Fundus fluorescein angiography (FFA) is not recommended if OCT excludes neovascularisation, but may be used to confirm diagnosis if OCT is unclear.
    • Antiangiogenic treatment is recommended for eyes with confirmed late AMD (wet active) and should be offered as soon as possible (within 14 days of referral).
    • AMD classification is based on the presence of specific signs and symptoms.
    • Normal eyes have no signs of AMD, with small 'hard' drusen (less than 63 micrometres) only.
    • Early AMD has low, medium, or high risk of progression, defined by drusen size, pigmentary abnormalities, and reticular drusen.
    • Late AMD is classified into three subcategories: indeterminate, wet active, and dry.
    • Late AMD (indeterminate) is characterized by retinal pigment epithelial (RPE) degeneration and dysfunction.
    • Late AMD (wet active) is defined by the presence of choroidal neovascularisation (CNV), occult or mixed CNV, retinal angiomatous proliferation (RAP), and polypoidal choroidal vasculopathy (PCV).
    • Late AMD (dry) is characterized by geographic atrophy, dense or confluent drusen, advanced pigmentary changes, and/or atrophy.

    Risk Factors for AMD

    • Older age is a risk factor for AMD.
    • Presence of AMD in the other eye increases the likelihood of AMD.
    • Family history of AMD is a risk factor.
    • Smoking, hypertension, and high BMI (≥ 30 kg/m²) are risk factors for AMD.
    • Diet low in omega 3 and 6, vitamins, carotenoids, and minerals, and high in fat, increases the risk of AMD.
    • Lack of exercise is a risk factor for AMD.

    Diagnosis and Referral

    • Fundus examination is recommended for people presenting with changes in vision or visual disturbances.
    • Early AMD diagnosis is confirmed using slit-lamp biomicroscopic fundus examination.
    • People with asymptomatic early AMD should not be referred to hospital eye services for further diagnostic tests.
    • Late AMD (dry) diagnosis is confirmed using slit-lamp biomicroscopic fundus examination.
    • Referral to hospital eye services is recommended for people with late AMD (dry) only for certification of sight impairment, access to low-vision services, or if new visual symptoms suggest late AMD (wet active).
    • Urgent referral to a macula service is recommended for people with suspected late AMD (wet active).
    • Optical coherence tomography (OCT) is recommended for people with suspected late AMD (wet active).
    • Fundus fluorescein angiography (FFA) is not recommended if OCT excludes neovascularisation, but may be used to confirm diagnosis if OCT is unclear.
    • Antiangiogenic treatment is recommended for eyes with confirmed late AMD (wet active) and should be offered as soon as possible (within 14 days of referral).

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    Description

    Learn about the different stages of Age-Related Macular Degeneration (AMD) including normal, early, and late AMD. Understand the signs and symptoms that define each stage.

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