Age-Related Macular Degeneration

Abstract

See related article, pages 613–617. Age-related macular degeneration (AMD) is a chronic degenerative disease of the macula (central part of the retina) that in its late or advanced stage results in progressive loss of central vision.1 There are 2 stages of this disease: early AMD, characterized by the appearance of a lipid-like deposit called drusen, and late AMD, in which patients have loss of vision as a consequence of 1 of 2 processes: geographic atrophy or neovascularization. In geographic atrophy (“dry” AMD), there is confluent atrophy of the choriocapillaries and associated retinal pigment epithelium. In neovascular (“wet”) AMD, there is an ingrowth of new vessels in the choroid that invades the retina, resulting in leakage of serous fluid, lipids, and blood with subsequent fibrous scarring. Although most stroke physicians are aware that AMD is an important cause of vision loss in elderly persons,2 many may not be aware that AMD and stroke are actually very similar diseases. Both conditions share common vascular risk factors (eg, smoking, hypertension), pathogenic mechanisms (eg, carotid artery …