Age-Related Macular Degeneration

Kiran Panesar, BPharmS (Hons), MRPharmS, RPh, CPh

Disclosures

US Pharmacist. 2015;40(6):22-26. 

In This Article

Diagnosis

In its early stages, ARMD is usually asymptomatic, but in some cases, patients may complain of acute vision loss, metamorphopsia, blurred vision, scotomas, or chronic visual distortion.[5,24] Since the onset of ARMD is gradual and often goes unnoticed for a long time, routine dilated eye examinations are recommended.[13] It is useful for primary care physicians to know their patients' profiles and be able to identify high-risk patients. The diagnosis is usually made by an ophthalmologist.

About 13% of patients with ARMD present with Charles Bonnet syndrome, in which mentally healthy patients experience loss of vision and complex visual hallucinations. The hallucinations are clear, welldefined, organized images over which the subject has little or no control.[25] Charles Bonnet syndrome is benign and frequently regresses as the visual cortex adapts to the loss of vision.[26]

Various screening tests may be used by an ophthalmologist to establish a diagnosis. These include visual acuity tests, dilated funduscopic examination, optical coherence tomography, fluorescein angiography, indocyanine green angiography, fundus autofluorescence, and ultrasonography. In advanced cases, referral to a retinal specialist may be required.

The Amsler grid is a 4×4-inch checkerboard chart that has proven to be an effective tool for monitoring the progression of ARMD at home.[5] Recently, novel computing systems using mobile handheld devices have been tested to monitor the retinal visual function of patients with ARMD.[27]

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