COMMENTARY

Age-Related Macular Degeneration

A Primer for the Primary Care Provider

Kyle N. Klingler, MD; Sophie J. Bakri, MD

June 11, 2012

Prevention of AMD

Modifiable risk factors should be optimized in all high-risk patients. Smoking cessation has the most profound effect on risk reduction because smoking doubles the risk for progression of AMD. After quitting smoking, one's risk for AMD appears to return to the baseline population risk after 20 years.^[5]

Patients with early AMD or significant risk factors should have regular dilated eye examinations to detect progression to intermediate or advanced AMD. Examinations should occur every 6-24 months (depending on age, with older patients being examined more frequently) if asymptomatic. Changes in vision suggestive of exudative AMD should prompt immediate referral to an eye doctor.^[1]

Patients with intermediate or advanced AMD in 1 eye should be offered antioxidant and zinc supplementation to reduce risk for progression. If patients are current or ex-smokers, they should use a formulation that omits beta-carotene, because this has been associated with an increased risk for lung cancer mortality.^[6] If asymptomatic, these patients should have a dilated eye examination every 6-24 months (depending on age) and should be seen immediately if they develop symptoms suggestive of exudative AMD.^[1] Each patient should be given an Amsler grid with instructions on its use to monitor for changes in central vision.

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Cite this: Kyle N. Klingler, Sophie J. Bakri. Age-Related Macular Degeneration - Medscape - Jun 11, 2012.

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