Retinal degenerations. Age related macular degeneration.
- Age-related macular degeneration (AMD)
- Progressive degenerative changes of the macula in old age due to aging processes of the retinal pigment epithelium
In AMD:
- Atrophic (dry, non-exudative)
- drusen – small, round, yellow lesions at the level of the RPE within the macula
- geographic atrophy of the RPE
- focal hyperpigmentation
- Exudative (wet, neovascular)
- CNV
- Haemorrhages
- Subrertnal scarring
Symptoms in AMD:
- Metamorphopsia (=distorted vision)
- Paracentral or central scotoma (=an area of partial alteration in the field of vision consisting of a partially diminished or entirely degenerated visual acuity that is surrounded by a field of normal – or relatively well-preserved – vision)
Fundus myopicus
- Definition:
- Retinal changes in the retina (Bruch's membrane) and choroid by prolonged bulbus in high myopia (over -6d)
- Clinic:
- Increasing loss of visual acuity (with macular involvement)
- Diagnostics:
- Funduscopy
- Conus temporalis: whitish sickle temporal of the papilla, which results from the fact that in a myopia, the choroid is greatly stretched and detached from the papilla (= choroidal atrophy), which allows you to look directly at the sclera
- Paint cracks due to defects of the breakage membrane
- Peripheral retinal degeneration between equator and ora serrata, which can lead to retinal detachment in the course
- In progressed findings, subretinal neovascularization, bleeding, and retinal edema are possible
- Fluorescence angiography at V.a. neovascularization
- Therapy:
- No causal therapy possible
- Correction of myopia by means of glasses or contact lenses
- For neovascularization, if necessary, laser coagulation and / or intravitreal injection of VEGF antagonists
- Prediction:
- Chronic progressive courses possible with increasing reduction of visual acuity
- Especially in case of neovascularization poor prognosis