TEMPLATE Classification and treatment of AMD (2210e022-84b8-450e-8c4f-370f8ae041c5)

TEMPLATE ID2210e022-84b8-450e-8c4f-370f8ae041c5
ConceptClassification and treatment of AMD
DescriptionDetermine the type of AMD and recommend a treatment accordingly.
PurposeDetermine the type of AMD and recommend a treatment accordingly.
References
Authorsname: Aitor Eguzkitza; organisation: Universidad Pública de Navarra - Complejo Hospitalario de Navarra; email: aitor.eguzkiza@unavarra.es; date: 2016-07-29
Other Details Languagename: Aitor Eguzkitza; organisation: Universidad Pública de Navarra - Complejo Hospitalario de Navarra; email: aitor.eguzkiza@unavarra.es; date: 2016-07-29
OtherDetails Language Independent{MetaDataSet:Sample Set =MetaDataSet:Sample Set , Copyright=Copyright, Owner=Owner, Speciality=Speciality}
Language useden
Citeable Identifier1013.26.101
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  • No AMD  [No or a few (<5) small drusen (<63 micrometres in diameter).]
  • Early AMD  [Many small drusen or a few intermediate-sized (63-124 micrometres in diameter) drusen, or macular pigmentary changes.]
  • Intermediate AMD  [Extensive intermediate drusen or at least one large (≥125 micrometres) drusen, or geographic atrophy not involving the foveal centre.]
  • Dry advanced AMD atrophic  [Geographic atrophy involving the foveal centre.]
  • Exudative or wet AMD  [Choroidal neovascularisation or evidence for neovascular maculopathy (subretinal haemorrhage, serous retinal or retinal pigment epithelium detachments, lipid exudates, or fibrovascular scar).]
  • Ungradable  [Patient ungradable due to the low quality of acquisitions or uncertainty of the evaluator.]
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  • Small drusen  [Drusen < 63 µm in diameter.]
  • Intermediate drusen  [Drusen 63-124 µm in diameter.]
  • Numerous intermediate drusen  [More than x drusen 63-124 µm in diameter.]
  • Large drusen  [Drusen ≥125 µm in diameter.]
  • Geographic atrophy  [A sharply demarcated, usually round or oval, area of atrophy of the RPE not involving the center of the fovea.]
  • Geographic atrophy involving foveal center  [Geographic atrophy of the RPE involving the foveal center.]
  • Choroidal neovascularization (CNV)  [Pathologic angiogenesis originating from the choroidal vasculature that extends through a defect in Bruch's membrane.]
  • Serous or hemorragic detachment  [Serous or hemorragic detachment of the neourosensory retina or RPE.]
  • Retinal hard exudates  [Hard exudates resulting from chronic intravascular leakage.]
  • Fibrovascular proliferation  [Subretinal and sub-RPE fibrovascular proliferation.]
  • Disciform scar (subretinal fibrosis)  [Subretinal fibrovascular tissue that usually becomes more fibrous within a few years and that is often the end result of CNV.]
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  • Very low VA (below 0.1 in first clinical encounter)
  • Healed lesions (Identified signs of previous treatments)
  • Multimorbidity (Coexistence of additional alterations on the retina)
  • Reaction to anti-VEGF (Suspicion of hypersensitivity to agents used in intravitreal injections)
  • No response to treatment (VA decreased below 0.1 three consecutive reviews)
  • Morphologic deterioration of the lesion
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  • Do not treat
  • Intravitreal anti-VEGF injection
  • High dose Antioxidant Vitamin and Mineral Supplements
  • Photodynamic Therapy (PDT)
  • Thermal Laser Photocoagulation Surgery
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  • Visual acuity decrease with macular fluid
  • Macular fluid
  • New macular haemorrhage
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