Mustafa Abdul Hameed Ismail, Nadeem Qureshi.
Most common clinical features of Age Related Macular Degeneration in Pakistan.
Al-Shifa J Ophthalmol Jan ;10(1):29-35.

Objective: To document the most common clinical symptoms and signs in patients diagnosed with ARM and ARDM. Study Design: Observational study. Subjects and Methods: The study was conducted at Retina clinic, Al-Shifa Trust Eye Hospital, Rawalpindi. Patients with age related macular degeneration were randomly selected over a period of 6 months. A pre-tested structured questionnaire was filled by a consultant in retina clinic. Patients were asked about the presenting symptoms already enlisted in the questionnaire. The pupil was dilated till adequate retinal examination was possible and the clinical signs observed and documented. Results: 209 eyes of 106 patients were examined. 18 were having age related maculopathy, 80 had atrophic type of ARMD and 111 were having exudative ARMD. The patients were having gradual blurring of central vision (91%), reading difficulty (28%) and metamorphopsia (9.6%) as the most common presenting symptoms. Macular drusen were the most common feature of maculopathy. Also, macular drusen were the most common clinical feature of eyes with Dry ARMD. Eyes with wet ARMD were having choroidal neo-vascular membrane (CNV) in 86% of cases and pigment epithelial detachment (PED) in rest of the 14%. Conclusion: There is need for making an organized screening protocol of macular degeneration for our population at risk. Every patient complaining of gradual blurring of vision and metamorphopsia should be examined for signs of ARMD. Macular drusen, hypo and hyper-pigmentation of RPE, CNV with exudation and hemorrhage or fibro-glial scar and PED must be identified on retinal examination for proper diagnosis and management of the ARMD.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com