Diagnosis[edit]

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Diagnosis of age-related macular degeneration rests on signs in the macula, irrespective of visual acuity. Diagnosis of AMD may include the following procedures and tests:

Diagnosis of age-related macular degeneration depends on signs in the macula, not necessarily vision.[1] Wet AMD is typically the advanced progression of dry AMD and will require additional diagnostic tools. Additionally, early diagnosis of wet AMD can prevent further visual deterioration and potentially improve vision.[1]

Diagnosis of dry (or early stage) AMD may include the following clinical examinations as well as procedures and tests:

  • The transition from dry to wet AMD can happen rapidly, and if it is left untreated can lead to legal blindness in as little as six months. To prevent this from occurring and to initiate preventive strategies earlier in the disease process, dark adaptation testing may be performed. A dark adaptometer can detect subclinical AMD at least three years earlier than it is clinically evident.[citation needed]
  • There is a loss of contrast sensitivity, so that contours, shadows, and color vision are less vivid. The loss in contrast sensitivity can be quickly and easily measured by a contrast sensitivity test like Pelli Robson performed either at home or by an eye specialist.[citation needed]
  • When viewing an Amsler grid, some straight lines appear wavy and some patches appear blank.[citation needed]
  • When viewing a Snellen chart, at least 2 lines decline
  • In dry macular degeneration, which occurs in 85–90 percent of AMD cases, drusen spots can be seen in Fundus photography
  • Using an electroretinogram, points in the macula with a weak or absent response compared to a normal eye may be found
  • Farnsworth-Munsell 100 hue test and Maximum Color Contrast Sensitivity test (MCCS) for assessing color acuity and color contrast sensitivity
  • Optical coherence tomography is now used by most ophthalmologists in the diagnosis and the follow-up evaluation of the response to treatment with antiangiogenic drugs.

Diagnosis of wet (or late stage) AMD may include the following in addition to the above tests:

  • Preferential hyperacuity perimetry changes (for wet AMD). Preferential hyperacuity perimetry is a test that detects drastic changes in vision and involves the macula being stimulated with distorted patterns of dots and the patient identification of where in the visual field this occurs.[2]
  • In wet macular degeneration, angiography can visualize the leakage of bloodstream behind the macula. Fluorescein angiography allows for the identification and localization of abnormal vascular processes.[citation needed]

Histology[edit]

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  • Pigmentary changes in the retina – In addition to the pigmented cells in the iris (the colored part of the eye), there are pigmented cells beneath the retina. As these cells break down and release their pigment, dark clumps of released pigment and later, areas that are less pigmented may appear
  • Exudative changes: hemorrhages in the eye, hard exudates, subretinal/sub-RPE/intraretinal fluid
  • Drusen, tiny accumulations of extracellular material that build up on the retina. While there is a tendency for drusen to be blamed for the progressive loss of vision, drusen deposits can be present in the retina without vision loss. Some patients with large deposits of drusen have normal visual acuity. If normal retinal reception and image transmission are sometimes possible in a retina when high concentrations of drusen are present, then, even if drusen can be implicated in the loss of visual function, there must be at least one other factor that accounts for the loss of vision.
  1. ^ a b National Guideline Alliance (UK) (2018). Age-related macular degeneration: diagnosis and management. National Institute for Health and Care Excellence: Clinical Guidelines. London: National Institute for Health and Care Excellence (UK). ISBN 9781473127876. PMID 29400919.
  2. ^ Faes, L.; Bodmer, N. S.; Bachmann, L. M.; Thiel, M. A.; Schmid, M. K. (2014-7). "Diagnostic accuracy of the Amsler grid and the preferential hyperacuity perimetry in the screening of patients with age-related macular degeneration: systematic review and meta-analysis". Eye (London, England). 28 (7): 788–796. doi:10.1038/eye.2014.104. ISSN 1476-5454. PMC 4094801. PMID 24788016. {{cite journal}}: Check date values in: |date= (help)CS1 maint: PMC format (link)

Comments

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Great use of secondary sources here. I think that you have done a nice job. I have a few notes:

  • Can you add Wikilinks to any terms here? If they are already defined earlier in the article, no need to add them in a second time
    • I added the current diagnosis section with strikeouts and my additions (in bold)
  • Is AMD defined earlier in the text?
    • Yes
  • Can you find any ways to use common english (lay terminology). I think that your first sentence could be re-worded so that someone who does not understand how the diagnosis is made. Is wet and dry explained earlier in the article? If not, may be a good idea to elucidate.
    • Wet and dry is explained earlier
    • I have simplified the first sentence.

Great work so far! JenOttawa (talk) 15:01, 6 November 2018 (UTC)

  • Thanks for taking care of these so quickly. Are you planning to bold the text in the article or is this for demonstration purposes?
    • The bolding is just to show my additions within this subsection. They will not be bold in the actual edits. Maybe there is a better way to show my edits?
      • This is fine, I just wanted to verify! Thanks. JenOttawa (talk) 16:34, 6 November 2018 (UTC)
I see that you described the holding on the article talk page. Sorry about missing this.JenOttawa (talk) 02:54, 7 November 2018 (UTC)
  • I added a citation needed tag, even if you re-use the same citation (if appropriate) this is fine.
    • I added the citations to my edits, but for the other needed citations, there are on sections that I did not edit. Most of them do not have citations, and those that do, the citations did not transfer over. When I will add my edits to the real page, I will add my citations and not disrupt the citations already present.
      • Thanks. You can add citation needed tags to things that are not cited. This will be helpful for future editors. JenOttawa (talk) 16:17, 6 November 2018 (UTC)
  • In your histology section there are no references used yet. Can you please also add references to your whole list of diagnostic tests?
    • As I said above, most things did not have citations but these were sections that I did not touch during this edit session.
  • Wikilink could be added to drusen spots
    • Drusen is linked to its wiki page
  • Please see other articles for how lists are dealt with and Wikipedia:Manual of Style/Layout regarding bullets and short sentences.
  • JenOttawa (talk) 16:15, 6 November 2018 (UTC)