Fast Five Quiz: Exudative (Wet) Age-Related Macular Degeneration (AMD)

F. Ryan Prall, MD

Disclosures

September 24, 2021

When a patient presents with signs and symptoms suggestive of wet AMD, the diagnosing physician should perform a thorough dilated examination of the fundus with slit lamp biomicroscopy.

To date, there are no established laboratory studies that assist in the diagnosis of AMD. Instead, techniques based on angiography and on tomography are available to confirm the presence of wet AMD.

Rapid-sequence fluorescein angiography is an office-based procedure for identifying and confirming the source of choroidal neovascularization. Serial images of the retina after injection of fluorescein dye reveal the progression of the dye through the choroidal and retinal vasculature, and abnormalities are identified in areas where the dye collects (hyperfluorescence) or is absent (hypofluorescence).

Optical coherence tomography (OCT) is a noninvasive diagnostic technique to identify retinal and subretinal pathology secondary to choroidal neovascularization. It helps identify several key pathologic markers of wet AMD. These include soft drusen, retinal pigment epithelial detachments, subretinal and intraretinal fluid, choroidal neovascularization, and cystoid macular edema.

OCT can also reveal the integrity of the photoreceptor and retinal pigment epithelial layers. For patients undergoing treatment for wet AMD, OCT is useful for monitoring therapeutic response.

Learn more about the workup of patients with suspected wet AMD.

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