Diagnosing AMD

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So when a patient arrives in our clinic and we think they have macular degeneration, the first step is, of course, to do a clinical exam and to look at them. But we usually also do an optical coherence tomography, which is an imaging device to look at their retina. From that, we can see things like atrophy for late, dry macular degeneration. We can see choroidal neovascularization for wet, age related macular degeneration. Historically, you might also add a fluorescein angiogram or indocyanine green angiogram to help characterize that neovascularization a little better. However, currently, really only OCT is needed to make the diagnosis of macular degeneration. Studies with anti-VEGF agents in wet macular degeneration have shown very specifically that the earlier you treat the patient, the better the visual outcomes. Only about 30% of patients gain vision. The rest, in general, maintain vision. So if you catch a patient early, that means their vision is usually pretty good and you can keep that vision pretty good. In dry macular degeneration, it's just as important to start treatment early. And the reason for that is, once the geographic atrophy has hit your fovea, there's no going back. The treatment only slows progression. So you'd want to start this treatment when the geographic atrophy has not necessarily hit the fovea. So for all treatment for macular degeneration, the earlier you treat a patient, the better it is.