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Age-Related Macular Degeneration (AMD).


In: Kolb H, Fernandez E, Nelson R, editors.


Webvision: The Organization of the Retina and Visual System [Internet]. Salt Lake City (UT): University of Utah Health Sciences Center; 1995-.
2008 Jan 01.


Age-related macular degeneration (AMD), the leading cause of worldwide blindness in the elderly, is a bilateral ocular condition that affects the central area of retina known as the macula. The macula lutea, which derives its name from the deposition of yellow xanthophyll pigments (see chapter on simple anatomy), is located temporal to the optic disc and is bounded by the temporal superior and inferior vascular arcades (Fig. 1). Although the macula comprises only four percent of retinal area, it is responsible for the majority of useful photopic vision. The fovea lies at the center of the macula (Fig. 1, asterisk) and is approximately 2mm in diameter. The fovea is particularly well seen in vertical section view using ocular coherence tomography techniques in living eyes (Fig. 2). The fovea contains the highest density of cone photoreceptor cells and is the only region of the retina where 20/20 vision is attainable. The macula accounts for almost 10% of the entire visual field. Thus, lesions developing in this region can have a major impact on visual function. AMD has a tremendous impact on the physical and mental health of the geriatric population and their families. Prior to 1990, AMD of all forms was often referred to as "senile macular degeneration" or SMD, a reflection of the fact that the vision loss associated with AMD manifests late in life when most affected individuals are looking forward to enjoying retirement activities and maintaining independence. Instead, millions with AMD suffer bilateral central vision loss such that they can no longer drive, read a newspaper, prepare meals, or enjoy recreational activities. For many patients, the visual impairment associated with AMD means a loss of independence, depression, increased financial concerns and the need to adapt to vision loss at a time when they are likely suffering from other debilitating conditions (1-5).

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