Term
| What is AREDS Category 1? |
|
Definition
Total area of <5 small drusen (<63um)
20/32 or better |
|
|
Term
| What is AREDS Category 2? |
|
Definition
multiple small drusen
AND/OR
20/32 or better in both eyes
<20 intermediate drusen (63-124um)
AND/OR
Pigment abnormalities |
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|
Term
| What is AREDS Category 3? |
|
Definition
1 large druse (>125 um)
extensive intermediate drusen (63-124um)
geographic atrophy NOT in macula center
At least 1 eye 20/32 or better |
|
|
Term
| What is AREDS Category 3a and 3b? |
|
Definition
3a: both eyes meet Category 3
3b: One eye has reduced VA NOT from AMD |
|
|
Term
| What is AREDS Category 4? |
|
Definition
No Advanced AMD (defined as geographic atrophy in macula center OR choroidal neovascularization) in the STUDY eye while fellow eye is either 4a or 4b
4a: Advanced AMD
4b: VA worse than 20/32 with AMD explaining VA loss |
|
|
Term
| What are the 3 anti-oxidants in AREDS? |
|
Definition
|
|
Term
| What is the non-antioxidant portion of AREDS? |
|
Definition
| 80mg Zinc with 2mg Copper |
|
|
Term
| Why is copper included in AREDS? |
|
Definition
| Long term zinc usage can induce copper deficiency |
|
|
Term
| What is the definition of moderate vision loss (MVL)? |
|
Definition
| >15 letters lost OR >3 lines lost OR doubling of visual angle in BCVA |
|
|
Term
| What is the definition of Severe Vision Loss(SVL)? |
|
Definition
| >30 letters lost OR >6 lines lost OR quadrupling of visual angle for BCVA |
|
|
Term
| According to AREDS study, when was no significant benefit found from taking AREDS formula? |
|
Definition
| MD Category 1 or 2 OR if Zinc was used alone OR antioxidants used alone |
|
|
Term
| When did AREDS formula show a benefit according to AREDS I study? |
|
Definition
20% reduction over 5 years in MVL
30% reduction over 5 years in SVL |
|
|
Term
| Which formula in the AREDS study showed statistically significant reduction in progression? |
|
Definition
|
|
Term
| Did AREDS slow the progressio of cataracst? |
|
Definition
|
|
Term
| DiD AREDS benefit both wet and dry AMD? |
|
Definition
|
|
Term
| What SE was induced by zinc? |
|
Definition
| increased urinary tract problems |
|
|
Term
| What element of AREDS should NOT be taken by smokers |
|
Definition
|
|
Term
| Did AREDS I study determine if AREDS formula may be prophylactic for early AMD findings or those with strong FHx of AMD? |
|
Definition
|
|
Term
| Was long term safety of AREDS (greater than 6.3 years) assessed? |
|
Definition
|
|
Term
| How many pack years was indicated for increased risk of AMD according to AREDS? |
|
Definition
|
|
Term
| Through meta-analysis, what is a smokers increased risk for CNV? For geographic atrophy? |
|
Definition
| 3x for CNV; 2x for geographic atrophy |
|
|
Term
| How much does beta carotene increase lung cancer risk in smokers according to the ATBC and CARET study? |
|
Definition
|
|
Term
| How much does obesity increase AMD risk according to AREDS? |
|
Definition
|
|
Term
| How does Omega3 consumption reduced risk of AMD? |
|
Definition
|
|
Term
| How much is AMD risk reduced by eating fruits? |
|
Definition
| 36% reduction of AMD w/ 3 or more servings of fruit per day vs only 1.5 servings |
|
|
Term
| What are the 7 AMD recommendations? |
|
Definition
1. Sunglasses/hat in sunlight
2. Do not smoke
3. Eat balanced diet
4. Tx of HTN
5. Routine PCP/OD visits
6. Monitor at home with Amsler
7. Consider AREDS only after consultation w/ PCP/OD |
|
|
Term
| How does AREDS II differ from AREDS I? |
|
Definition
lutein/zeaxanthin and Omega3 the focus of AREDS II
Impact on cataract and MVL
eliminating beta-carotene for smokers
reducing zinc in original formula
validation of photographic AMD scales |
|
|
Term
| What was the age range for AREDSII? |
|
Definition
|
|
Term
| What type of AMD qualified for AREDS II study? |
|
Definition
| bilateral large drusen (125 um or greater) w/ one eye possibly having advanced AMD |
|
|
Term
|
Definition
Lutein Antioxidant Supplement Trial
'Kitchen sink' study of anti-oxidants and nearly every element on the periodic table thrown in for good measure |
|
|
Term
| What was evaluated in the LAST study? |
|
Definition
VA
CSF
Amsler grid
Glare recovery
Macular pigment level
Lens opacification
Daily Vision Scale (lower scores worse) |
|
|
Term
| According to LAST study, how much did macular pigment density change when taking lutein? |
|
Definition
| 50% increase in pigment w/ lutein supplementation |
|
|
Term
| Did lutein significantly improve visual fxn according to LAST study? |
|
Definition
|
|
Term
| Is AMD now thought to be in part a nutrition related disorder? |
|
Definition
|
|
Term
| What is the mechanism of lutein protection? |
|
Definition
| Lutein absorbs UV --> prevents free radical formation --> preserves PR and RPE fxn --> protection from AMD |
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|
Term
| What are the validated treatments for advanced AMD? |
|
Definition
Laser photocoagulation
Photodynamic Therapy
Intravitreal Therapy |
|
|
Term
| What are the 4 choroidal neovascular criteria? |
|
Definition
1. Extrafoveal (200-2500 um from fovea)
2. Juxtafoveal (1-199 um from fovea)
3. Subfoveal (<3.5 disc areas)
4. Subfoveal Recurrent CNV (contiguous w/ laser scar) |
|
|
Term
| Which eyes had better benefit from Macular photocoagulation study? Worse? |
|
Definition
Eyes w/ smaller lesion and worse initial VA benefitted most
large subfoveal CNV w/ good initial VA are not good candidates for focal laser coagulation |
|
|
Term
| How is verteporfin excreted? |
|
Definition
|
|
Term
| How do verteporfin treated eyes compare to untreated at 1 year? 2 years? |
|
Definition
67% remain stable or improved WITH verteporfin
39% remained stable or improved WITHOUT verteporfin
At 2 years verteporfin group required fewer tx |
|
|
Term
| According to the VIP study, what patients may be worse off after verteporfin tx? |
|
Definition
| If large CNV or good VA (>20/50) |
|
|
Term
| Molecularly, what is Macugen? |
|
Definition
|
|
Term
| What is Macugens mechanism of action? |
|
Definition
|
|
Term
| What does macugen specifically target? |
|
Definition
|
|
Term
| Molecularly, what is Lucentis? |
|
Definition
| Ab fragment of Avastin (anti-angiogenesis drug) |
|
|
Term
| What does Lucentis target? |
|
Definition
|
|
Term
| Can Avastin be used off label as a substitute for Lucentis? |
|
Definition
| yes, CATT study found no difference. However, FDA is investigating problems with Avastin induced blindness and infxn |
|
|
Term
|
Definition
| new anti-VEGF drug (afilbercept) |
|
|
Term
| Besides AMD what can Eylea be used for? |
|
Definition
|
|
Term
| What is the tx regimen for Eylea? |
|
Definition
|
|
Term
| What is IVTA? What are the results? |
|
Definition
| Intravitreal Triamcinolone Acetonide Trial; No reduction in SVL at 1 yr or change in lesion size at 1 yr |
|
|
Term
| What are some ideas for ARMD tx that have not worked? |
|
Definition
Interferon Alpha
Thalidomide
Prinomastat
Transpupillary thermotherapy
Submacular surgery
Radiotherapy
Intravitreal corticosteroids |
|
|
Term
| How big is a square on an amsler grid? How big is the grid overall? |
|
Definition
| subtends 1* at 1 foot; subtends 20* |
|
|
Term
| Can a PHP detect early CNV prior to FA? |
|
Definition
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