Last reviewed: 29 Jun 2021
Last updated: 29 May 2018



History and exam

Key diagnostic factors

  • sudden-onset blurring or distortion of vision
  • drusen
  • macular pigmentary changes
  • geographic atrophy
  • choroidal neovascularization

Other diagnostic factors

  • pigment epithelial detachment (exudative AMD)
  • progressive loss of vision in 1 or both eyes
  • fibrovascular scar formation
  • pseudodrusen

Risk factors

  • increasing age
  • smoking
  • FHx of disease

Diagnostic investigations

Investigations to consider

  • fluorescein angiography
  • indocyanine green (ICG) angiography
  • autofluorescent imaging

Treatment algorithm



Paul Bishop, PhD, FRCOphth

Consultant Ophthalmologist

Manchester Royal Eye Hospital

Central Manchester University Hospitals NHS Foundation Trust

Professor of Ophthalmology & Matrix Biology

Centre for Hearing and Vision Research

University of Manchester



PB has undertaken research activities and received research grants (from charities and the Medical Research Council) that relate to basic mechanisms underpinning age-related macular degeneration. He is an inventor on a patent for a new treatment for age-related macular degeneration filed by the University of Manchester. He does not believe that any of these activities are competing interests with respect to the content of the monograph.


Dr Paul Bishop would like to gratefully acknowledge Dr Leon Charkoudian and Dr Joshua L. Dunaief, the previous contributors to this monograph. LC and JLD declare that they have no competing interests.

Peer reviewers

Sharon Fekrat, MD

Associate Professor

Vitreoretinal Surgery

Duke University Eye Center




SF declares that she has no competing interests.

Usha Chakravarthy, MBBS, FRCS, PhD

Professor of Ophthalmology and Vision Sciences

Centre for Vision Science

Queen's University Belfast




UC declares that she has no competing interests.

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