History/Chief Complaint

  • A 61-year-old male presented for follow-up with dry AMD and multiple drusen in the posterior pole extending outside the macula. Patient complained of cloudy and distorted vision in both eyes. He also reported missing areas of central vision in his left eye. Patient has emphysema and continues to smoke one pack a day after cutting down from 3 packs a day for over 45 years. There is also a family history of glaucoma and high blood pressure. Patient had also recently began taking lutein and zeaxanthin supplements daily. >/li>

Clinical Findings

  • BCVA: 20/20-2 OD 20/40 OS
  • Goldmann IOP: 10 OU
  • Fundus Exam: Large soft confluent macular drusen and scattered hard drusen were noted in both eyes.
  • There were no signs of CNV in the right eye and no retinal holes or tears OU. An area of possible CNV nasal to the fovea in the left eye was revealed. (This appeared totally unchanged from a previous visit when fluorescein angiography (FA) failed to reveal CNV.)

Topcon 3-D OCT

  • OCT sections through both eyes revealed multiple large elevated drusen.
  • Drusen appear as hyporeflective dome-shaped lesions under the RPE causing dramatic RPE elevation centrally.

Diagnosis

  • AMD with drusen extending throughout the posterior pole.

Disposition

  • Home monitoring with Amsler Grid daily in both eyes.
  • Recommend quit smoking and continue taking lutein and zeaxanthin supplements daily.