Ivan Fiser (Prague, Czech Republic)

Advantages:

1. We find useful to carefully follow up eyes with atrophic AMD and macular drusen. Not only the drusen, but also the fading of drusen, and the conversion to geographic atrophy can be a prologue to CNV. The combination of OCT and FA, together with other usual examination methods, can distinguish between questionable findings.

2. A coexistence of macular atrophy and “EMP” does not prevent visual improvement after EMP peeling. Moreover, the release of vitreomacular traction (or adhesion) theoretically can help remove one of several factors contributing to ARMD.

Methods:

We will demonstrate the findings in eyes where CNV developed after the regression of drusen, and the emergence of GA, or where a RAP developed from GA without drusen, or directly from drusen. We will also show a misdiagnosis of RPE rupture which appeared similar to simple RPE atrophy, a case-report of VA improvement after EMP peeling despite a background of atrophic AMD, and a case-report of showing evidence of benefit following the release of vitreomacular traction.

Effectiveness / Safety:

We are not showing any statistical evidence but a didactic survey.

Take home message:

Let us not underrate dry AMD and be alert when drusen disappear. Let us not be afraid of vitrectomy in AMD; there are suggestions that it may even be beneficial (due to possible vitreomacular interaction).