A 69-year-old man is brought to the emergency department 30 minutes after sudden onset of painless loss of vision in his right eye. Over the last several years, he has noticed increased blurring of vision; he says the blurring has made it difficult to read, but he can read better if he holds the book below or above eye level. He has smoked 1 pack of cigarettes daily for 40 years. He has no history of diabetes mellitus or hypertension Ophthalmologic examination of the right eye shows a grayish discoloration of the macula with areas of adjacent hemorrhage. Which of the following should be specifically targeted in treatment of this patient's condition?

Question

A 69-year-old man is brought to the emergency department 30 minutes after sudden onset of painless loss of vision in his right eye. Over the last several years, he has noticed increased blurring of vision; he says the blurring has made it difficult to read, but he can read better if he holds the book below or above eye level. He has smoked 1 pack of cigarettes daily for 40 years. He has no history of diabetes mellitus or hypertension Ophthalmologic examination of the right eye shows a grayish discoloration of the macula with areas of adjacent hemorrhage.  Which of the following should be specifically targeted in treatment of this patient's condition?

Quizplus · Accepted Answer

Eductional Objective: Wet age-related macular degeneration is characterized by retinal neovascularization due to increased vascular endothelial growth factor (VEGF) levels.  Patients typically have acute vision loss and metamorphopsia with funduscopy showing a grayish-green subretinal membrane and/or subretinal hemorrhage.  VEGF release in wet age-related macular degeneration (wet AMD or neovascular AMD) causes growth of new, friable blood vessels in the choriocapillaris, which are prone to bleeding and leaking. Treatment includes smoking cessation and VEGF inhibitor therapy (eg, ranibizumab, bevacizumab).

A 69-Year-Old Man Is Brought to the Emergency Department 30