Age-related Macular Degeneration follow-up

Regular monitoring is key to managing Age-Related Macular Degeneration (AMD) and preventing severe vision loss. The approach varies depending on the type (dry or wet) and severity of the disease.

1. Monitoring Dry (Atrophic) AMD

Objectives

Detect progression to advanced forms (such as geographic atrophy or wet AMD).

Adjust preventive measures and supplements.

Frequency of Checkups

Early stage (small drusen): Every 12-24 months.

Intermediate stage (large drusen or pigmentary changes): Every 6-12 months.

Geographic atrophy (advanced): Every 3-6 months.

Recommended Tests

✔ Visual acuity (monitoring changes in central vision).

✔ Amsler grid (self-assessment at home to detect distortions).

✔ Optical Coherence Tomography (OCT) (evaluates retinal thickness and atrophy).

✔ Fundus examination with pupillary dilation (looks for new drusen or pigmentary changes).

Patient Recommendations

Self-monitoring with the Amsler Grid (once a week).

AREDS2 supplements (if prescribed by the ophthalmologist).

UV and blue light protection (sunglasses with a filter).

Diet rich in lutein/zeaxanthin (spinach, broccoli, corn).

2. Follow-up in Wet AMD (Neovascular)

Objectives

Evaluate response to treatment (anti-VEGF injections).

Detect reactivation of neovascularization.

Frequency of Follow-up

Active phase (after starting treatment): Every 4-8 weeks.

Stable phase: Every 2-4 months.

Clinical Tests to be Performed

✔ OCT (monitors edema, intraretinal or subretinal fluid).

✔ Fluorescein/indocyanine green angiography (if occult neovascularization is suspected).

✔ Visual acuity (to evaluate treatment efficacy).

Anti-VEGF Treatment Protocol

Loading phase: 3 consecutive monthly injections (Lucentis, Eylea, etc.).

Maintenance phase: Customized intervals based on response ("treat and extend" or "PRN").

Warning Signs Requiring Urgent Attention

Sudden appearance of distortion (crooked lines).

Central dark spot that grows.

Sudden vision loss.

Importance of Adherence

In dry AMD: 10-20% progresses to wet AMD; early detection saves vision.

In wet AMD: Skipping checkups or injections increases the risk of blindness.