Age-related macular degeneration (AMD) is globally the most common cause of blindness in elderly with significant economic burden to individuals and societies. It can be dry or wet type with gradual versus abrupt affection of vision respectively. Visual outcomes of fellow eyes of patients with unilateral wet AMD can be improved with regular follow-ups using optical coherence tomography (OCT) and OCT angiography (OCT-A) to detect features of progression and home monitoring techniques.
On OCT-A, the fellow eyes of wet AMD may present with a subclinical choroidal neovascularization (CNV) or areas of choriocapillaris signal loss contrary to the normal grainy appearance. The double-layer sign on structural OCT can predict the possibility of a subclinical CNV in OCT-A. Type 1 CNV is associated with more advanced fellow eye findings than type II CNV.
Life-style modification and nutritional supplements are advocated in early and intermediate AMD. No proven treatment for geographic atrophy while exudative AMD is managed with repeated intravitreal injection of anti-VEGF. Hence proper monitoring with OCT/OCT-A and timely treatment can improve visual prognosis of AMD patients through detection of these features.