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Patient handout

Age-related macular degeneration (dry, GA, and wet/neovascular)

PRODUCTION

1. Your condition

This handout is for age-related macular degeneration (dry, ga, and wet/neovascular). Your care team identified this based on: distorted straight lines (metamorphopsia) on amsler grid or in daily life in a patient >50 — wet amd until proven otherwise (aao ppp amd 2024).

Other reasons your team may use this plan: sudden central blur, scotoma, or visual loss in an older adult — possible new wet amd or progression of ga (aao ppp amd 2024); drusen, pigment changes, or geographic atrophy noted on routine eye examination >50 years — entry to areds staging and prophylaxis (pmid 23644932); first-degree family history of amd or advanced amd already in the fellow eye — high-risk monitoring and areds2 candidacy (aao ppp amd 2024).

2. Your medications

Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.

MedicationStarting doseHowWhenWhat it does
areds2_supplementation_no_beta_caroteneAREDS2 — Age-Related Eye Disease Study 2 Research Group JAMA 2013 (PMID 23644932): substituting lutein 10 mg + zeaxanthin 2 mg for beta-carotene preserved efficacy and avoided the beta-carotene lung-cancer signal in former smokers (23 vs 11 lung-cancer cases in original AREDS).
smoking_cessation_and_mediterranean_dietAAO PPP AMD 2024 — smoking is the strongest modifiable risk; Mediterranean dietary pattern (leafy greens, oily fish, nuts) associated with lower progression.

Plan: AMD — pathway-specific ladder (AREDS2 dry / complement-inhibitor GA / anti-VEGF wet)

3. When to call your provider

Contact your care team if any of the following happen:

  • New metamorphopsia + IRF/SRF/PED on OCT → urgent retina referral for anti-VEGF within 2 weeks
  • Post-injection pain + redness + hypopyon → ophtho.endophthalmitis.core.v1
  • New wet conversion during complement-inhibitor therapy → add anti-VEGF

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

  • New metamorphopsia + IRF/SRF/PED on OCT in an AMD patient — wet conversion
  • Pain + hypopyon + visual loss after intravitreal injection(life-threatening)
  • Patient with current or former smoking history considered for an old (AREDS, not AREDS2) beta-carotene-containing formulation
  • Considering brolucizumab in a patient with prior intraocular inflammation
  • New wet conversion (IRF/SRF/PED) during pegcetacoplan or avacincaptad therapy

5. Follow-up

Lifelong arc. Reassess AREDS stage and fellow-eye risk yearly. Counsel smoking cessation (largest modifiable lever). Co-manage cataract surgery: do not defer in patients with concurrent intermediate AMD — better functional outcome generally outweighs theoretical AMD-progression concern (AREDS data reassuring). Low-vision rehabilitation for irreversible central loss; driving-vision regulations; depression and falls-screen in advanced bilateral disease (AAO PPP AMD 2024).

6. Sources

Guideline: AAO Preferred Practice Pattern AMD 2024 cycle + AREDS2 (Age-Related Eye Disease Study 2 Research Group, JAMA 2013, PMID 23644932) + OAKS & DERBY pegcetacoplan (Heier et al, Lancet 2023, PMID 37865470) + GATHER1 & GATHER2 avacincaptad pegol vision-loss analysis (Danzig/Khanani et al, Ophthalmol Retina 2024, PMID 38719191) + TENAYA & LUCERNE faricimab nAMD (Heier et al, Lancet 2022, PMID 35085502)

  1. pubmed.ncbi.nlm.nih.gov/23644932
  2. pubmed.ncbi.nlm.nih.gov/37865470
  3. pubmed.ncbi.nlm.nih.gov/38719191