Multimedia
 | Media file 1: A normal-appearing macula of the left eye. Note the even pigmentation of the retinal pigment epithelium and the absence of any yellow excrescences (drusen) in the fovea. The optic nerve has unrelated changes. |
 | Media file 2: An angiogram of Media file 1. In angiography, fluorescein dye is passed through a peripheral vein and transmits through the vascular system. The dye fluoresces in the vasculature, as seen here. There are no vascular prominences in the macula or any areas of dye pooling or staining. The abnormal vessels in the optic nerve, however, do show dye leakage. |
 | Media file 3: Mild nonexudative age-related macular degeneration is shown with the presence of drusen (yellow deposits) in the macular region. |
 | Media file 4: An angiogram of Media file 3, showing the staining of drusen. Drusen absorb dye and, in the late frames of the angiogram, show hyperfluorescence. This staining is distinguished from the leakage that occurs when the dye spreads outside the boundary of the lesion. |
 | Media file 5: A more advanced case of nonexudative age-related macular degeneration (AMD). This image shows drusen that are larger, more confluent, and soft. Soft drusen are defined as drusen that have indistinct borders. Such drusen are more likely to convert to wet AMD. There are a few areas of atrophy, where the retinal pigment epithelium (RPE) has lost pigmentation. The retinal cells overlying atrophic RPE are generally nonfunctional and result in a scotoma. |
 | Media file 6: An angiogram of Media file 5. The atrophic retinal pigment epithelium (RPE) demonstrates staining of the underlying choroidal vasculature. Normally, the intact RPE masks the presence of choroidal fluorescence. However, when the RPE atrophies, the underlying dye appears as an area of hyperfluorescence in the early stages of angiography. In the late stages, the drusen lose fluorescence in concert with (or with a small time lag) the rest of the retinal layers. |
 | Media file 7: A more advanced case of dry age-related macular degeneration. Several areas of atrophy are present as well as areas of significant pigment mottling in the macula. The large drusen inferior to fixation are poorly distinguished from each other. |
 | Media file 8: An angiogram of Media file 7. The atrophic areas are easily distinguished by the hyperfluorescence of the retinal pigment epithelium (RPE) in the mid phase of the angiogram. There are areas where there is hypofluorescence of dye due to masking caused by the increased pigmentation. No areas of frank dye leakage or exudative age-related macular degeneration (AMD) are apparent. A "hot cross bun" pattern of dry AMD related pigment changes is evident near the fovea. |
More on ARMD, Nonexudative |
| Overview: ARMD, Nonexudative |
| Differential Diagnoses & Workup: ARMD, Nonexudative |
| Treatment & Medication: ARMD, Nonexudative |
| Follow-up: ARMD, Nonexudative |
 Multimedia: ARMD, Nonexudative |
| References |
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Further Reading
Keywords
nonexudative ARMD, nonexudative age-related macular degeneration, nonexudative AMD, age-related macular degeneration, AMD, dry macular degeneration, macular degeneration, senile macular degeneration, geographic atrophy, drusen, drusenoid changes, pigment epithelial degeneration, photodynamic therapy, PDT, transpupillary thermotherapy, TTT, IRIS medical laser, rheopheresis, complications of age-related macular degeneration prevention trial, CAPT, drusen ablation, laser to drusen
