AMD Follow-up

Dry and Wet AMD Follow-up: Protocols and Recommendations

Regular follow-up 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 the severity of the disease.

1. Follow-up for Dry (Atrophic) AMD

Objectives

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

Adjust preventive measures and supplements.

Frequency of Follow-ups

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

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

Advanced geographic atrophy: Every 3-6 months.

Recommended Tests

✔ Visual acuity (monitoring changes in central vision).

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

✔ Optical coherence tomography (OCT) (assesses retinal thickness and atrophy).

✔ Dilated fundus examination (looks for new drusen or pigmentary changes).

Patient Recommendations

Self-monitoring with Amsler grid (once a week).

AREDS2 supplements (if prescribed by the ophthalmologist).

UV and blue light protection (filtering glasses).

Lutein/zeaxanthin-rich diet (spinach, broccoli, corn).

2. Follow-up for Wet AMD (Neovascular)

Objectives

Evaluate response to treatment (anti-VEGF injections).

Detect reactivation of neovascularization.

Frequency of Follow-ups

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

Stabilized Phase: Every 2-4 months.

Clinical Tests to be Performed

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

✔ Fluorescein/indocyanine green angiography (if occult neovessels are suspected).

✔ Visual acuity (to assess 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 to Seek Urgent Care

Sudden appearance of distortion (crooked lines).

Widening central dark spot.

Sudden vision loss.

Importance of Compliance

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

In wet AMD: Skipping check-ups or injections increases the risk of blindness.