Question
At presentation, a 70-year-old man has sudden loss of vision. Examination shows soft macular drusen in one eye and a macular hemorrhage and exudation in the affected eye. The most likely diagnosis is:
| A. |
neovascular (wet) age-related macular degeneration.
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| B. |
presumed histoplasmosis syndrome.
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| C. |
arterial macroaneurysm.
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| D. |
diabetic retinopathy.
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Show Answer
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Correct Answer � A
Explanation
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Answer: A. neovascular (wet) age-related macular degeneration.
Explanation:
Neovascular or exudative AMD, the “wet” form of advanced AMD, causes vision loss due to abnormal blood vessel growth (choroidal neovascularization) in the choriocapillaris, through Bruch’s membrane. It is usually, but not always, preceded by the dry form of AMD. The proliferation of abnormal blood vessels in the retina is stimulated by vascular endothelial growth factor (VEGF). Because these blood vessels are abnormal, these are also more fragile than typical blood vessels, which ultimately leads to blood and protein leakage below the macula. Bleeding, leaking, and scarring from these blood vessels eventually cause irreversible damage to the photoreceptors and rapid vision loss if left untreated.
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