Wydanie 3/2007

Wysiękowe AMD - choroba obojga oczu. Analiza przypadków klinicznych

Exudative AMD - Bilateral Disease. Clinical Cases Analysis

Małgorzata Figurska, Rafał Pawlik

Klinika Okulistyki Wojskowego Instytutu Medycznego w Warszawie Kierownik: prof. dr hab. n. med. Andrzej Stankiewicz

Summary: AMD is considered to be a civilization-related disease with genetic predisposition, the onset of which is provoked by environmental and behavioral factors. With such pathogenesis one should assume this to be a disease which affects both eyes. Frequent symmetry of lesions in cases where both eyes are affected prove this theory. The major prognostic factors for the risk of visual loss in the second eye are: age of patients (nearly 50% of those aged over 80 years), gender (women), family history, history of heavy smoking in the previous 25 years, long term thiazide-diuretic treatment and the type of AMD in the first eye. The aim of this article is to discuss the dynamics of AMD and to present the effects of photodynamic therapy in 3 women aged 68-73 years (average 70), in whom exudative AMD was diagnosed in both eyes over the period of several months. We also wish to draw attention to risk factors of AMD and to systematize prophylactic approach which would allow early diagnosis of this degeneration. Conclusions: 1. Patients with unilateral exudative AMD should be monitored carefully - fundus examination should be repeated every 3 months or even more frequently, Amsler test must be done on the regular basis. 2. The evaluation of exudative AMD and response to PDT may vary in each eye of the same patient. 3. Patients with unilateral AMD and hypertension should avoid long-term thiazide diuretic treatment.

Keywords: bilateral exudative AMD, photodynamic therapy, risk factors, prophylaxis