Testing & Treatments
A complete and comprehensive ophthalmic examination is important in the assessment of AMD. Patients will receive vision testing, drops to dilate pupils, and a complete examination of the front and back of the eye. Pupillary dilation may create blurring, and therefore, it is often best if a driver accompanies the patient, although it is not absolutely required.
Testing
Patients with AMD may have several types of tests to assess the disease. Patients may undergo color photography of the macula and retina to document drusen, pigment changes, and other characteristics of AMD.
1. Fluorescein Angiography
Fluorescein angiography (fluorescein angiography is performed by injecting sodium fluorescein dye into a peripheral vein with a small needle; this dye then goes through the body and eyes, as well as the macula to assess blood flow and to determine whether choroidal neovascularization is present) may be performed in the office to assess whether there is evidence of wet AMD. It is regarded as a safe test, but patients should expect some yellowish skin discoloration and orange urine. Most patients have no difficulty with this testing, although a low percentage of patients will experience some nausea. Any angiogram test, however, can be associated with allergic or even more severe reactions, and therefore, this test is reserved for patients in whom wet AMD is noted or suspected.
1. OCT Imaging
OCT Imaging is a non-invasive optical coherence tomogram examination of the macula; an OCT uses low energy laser to scan the macula and determine whether there is leakage beneath the macula or swelling within the macula, potentially signifying wet AMD. It is a common non-invasive test used to assess the status of the macula. It can be used to determine whether there is evidence of choroidal neovascularization and wet AMD. It can also be used to assess response to treatment in patients with wet AMD. OCT is performed with no risk to the patient.
What The Doctor See’s
For patients with dry AMD, an ophthalmologist may note drusen accumulation within the macula, pigmentary changes within the macula, or advanced forms of dry AMD such as geographic atrophy. Patients with wet AMD are noted to have fluid in the macula, and hemorrhage or blood is commonly noted as well. There may be larger hemorrhages, and these are typically associated with sudden and severe vision loss. Other blister elevations (retinal pigment epithelial detachments) of fluid in the macula may or may not be symptomatic.
