An Overview of Age-Related Macular Degeneration

Key opinion leaders in ophthalmology provide an overview of age-related macular degeneration and comment on clinical recommendations for assessing symptoms.

Charles C. Wykoff, MD, PhD: Hello, and welcome to this Ophthalmology Times® Viewpoints titled “Current and Emerging Therapies for Wet Age-Related Macular Degeneration.” I’m Dr Charles Wykoff with Retina Consultants of Texas in Houston. Joining me today in this virtual discussion are my friends and colleagues Dr Diana Do, a professor of ophthalmology and the vice chair for clinical affairs at the Byers Eye Institute at the Stanford University School of Medicine in Palo Alto, California; Dr Sophie Bakri, the chair and a professor of ophthalmology at the Mayo Clinic in Rochester, Minnesota; and Dr Mark Breazzano, an assistant professor of ophthalmology at the Wilmer Eye Institute at Johns Hopkins Medicine in Baltimore, Maryland. Today we are going to discuss topics pertaining to the management of wet AMD [age-related macular degeneration], including the treatment landscape as well as the latest data on potential treatment strategies that lie on the horizon. With that, let’s get started.

In our first segment, let’s talk about general wet AMD disease state. What do these patients look like when we’re seeing them in our clinic? Sophie, I’ll start with you. Give us an overview of what the typical wet AMD patient looks like, what their complaints are, and how long they’ve noticed symptoms. If they’re symptomatic nowadays, how do they present before you actually see the patient?

Sophie J. Bakri, MD: Typically we’re seeing patients over the age of 55 coming in referred to us as retina specialists. The majority will have symptoms. There will be a minority who may not have symptoms or perhaps have other conditions such as dementia where they may not notice the symptoms. They’re coming in complaining of blurred vision, scotoma, missing letters, wavy lines. Sometimes there’s a very clear answer, but other times it’s been a more gradual decline in vision over months. We do tend to find that when the second eye is involved, patients have symptoms much sooner and they’re on much higher alert.

Charles C. Wykoff, MD, PhD:When any of the 3 of you are seeing patients with intermediate dry AMD or mild dry AMD, what’s your 2- or 3-sentence commentary you give those patients about what symptoms to be on the lookout for? What’s your clinical recommendation to those patients before they convert to wet AMD?

Diana V. Do, MD: I echo what Sophie said. A lot of these patients at baseline, depending on their dry AMD, they may have some baseline distortion from drusen. But I usually advocate that they tell me if they have any new scotomas or changes in vision, and that they shouldn’t be shy in contacting our office so we can see them urgently if there’s a change. We’re learning from our colleagues that the earlier you treat wet AMD, the better the change for good vision preservation. We don’t want to wait and delay treatment.

Transcript edited for clarity.

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