In age-related macular degeneration (AMD), the visual prognosis is dramatically worse in neovascular (wet) AMD compared to geographic atrophy (dry AMD) because:

• A Wet AMD is bilateral in nearly 100% of cases at onset
• B Choroidal neovascularization causes rapid sub-retinal fluid/blood accumulation leading to foveal photoreceptor destruction within weeks if untreated ✓
• C Wet AMD is associated with vitreous hemorrhage requiring PPV
• D Geographic atrophy has a higher incidence of optic nerve involvement

Explanation

Neovascular (wet) AMD involves growth of abnormal choroidal neovascular membranes (CNV) beneath or through the RPE, causing leakage of fluid, blood, and lipid under the retina and RPE. This results in rapid, severe central vision loss (within days to weeks) if untreated due to photoreceptor disruption and disciform scar formation. Dry AMD (geographic atrophy) progresses slowly over years. Anti-VEGF therapy has transformed wet AMD management.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.