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Case 2: baseline Fundus Photography 2014Large soft drusen OU = intermediate AMD 

Case 278yo white female with hypertension, hypercholesterolemia, cardiovascular disease (stents and bypass), recurrent bladder cancer, Parkinson’s disease, and diet-controlled diabetes. All systemic conditions are stable and controlled.(+)Family history  -  mother had vision loss due to AMD (unsure wet vs dry)Never a smokerNot obeseCardiovascular disease, hypertension, hypercholesterolemia are risk factorsVA was easily correctable to 20/20

Dark Adaptation (DA) in eyes with SDDs22  Impairments in dark adaptation increases with age, severity of AMD, worse visual acuity, and presence of SDDsSDDs often cause deep impairment to dark adaptation and this impairment occurs earlier in the AMD diagnosis with SDDs than AMD with soft drusenStudies show a deep delay in

Low luminance acuity and contrast sensitivity21Low luminance acuity scores are significantly worse in patients with SDDs compared to normal controlsDecreased contrast sensitivity is a high predictor to the presence of SDDsAn early symptom in patients with SDDs is difficulty seeing in dim illumination or they recognize it takes longer for dark adaptation going from

Microperimetry in eyes with SDDsPresence of SDDs significantly reduces threshold sensitivity in microperimetry testing21Retinal sensitivity in eyes with SDD was lower in all areas of the macula compared to normal controlsMean retinal sensitivity in the superior macula was significantly lower than any other quadrant which is where SDDs first develop The number of SDD lesions

Functional Testing of SDDs Microperimetry Low luminance acuity and contrast sensitivity Dark adaptation

Case 1: OCTA 2023  VA 20/40+1 OSOCT-A at level of choriocapillaris shows large neovascular membrane. 

Case 1: OCTA 2023  VA 20/25+2 ODOCT-A at level of RPE/outer retina shows large neovascular membrane.

Case 1: Progression OS  Images from 2023:OS treatment has been changed to Vabysmo q6wks

Case 1: Progression OD - conversion to CNVM  Images from 2023:OD CNVM conversion caught by retina specialist during routine antiVEGF treatment scheduled for OS, he just started Eylea OD as well as OS 6 weeks prior to this image.