In a Clinical Crossroads article published in May 2006,1 Jorge Arroyo, MD, discussed the epidemiology and pathophysiology of age-related macular degeneration (AMD). The discussion centered on Dr G, a 76-year-old semiretired surgeon devastated by the loss of depth perception in his right eye because it prevented him from continuing to practice surgery. Three years prior to the conference, Dr G noticed subtle vision changes, which progressed, resulting in a diagnosis of AMD. After the diagnosis, Dr G received photodynamic therapy to the right eye 5 times, twice with the experimental addition of intraocular triamcinolone. Despite these treatments, Dr G lost vision in his right eye. At the time of the conference, Dr G was primarily concerned with protecting the vision in his left eye, allowing him to maintain autonomy and function with general ease. Dr Arroyo suggested that Dr G meet with a visual rehabilitation specialist to discuss strategies to help him overcome the functional limitations of his vision loss. Dr Arroyo also advised Dr G to adhere to a diet high in fruits, vegetables, fish, and nuts and to take a daily Age-Related Eye Disease Study (AREDS)–recommended antioxidant and zinc formulation. Finally, Dr Arroyo recommended that Dr G's depressive symptoms be addressed and treatment provided if necessary.
Farag N, Ship AN, Arroyo JG. Update: A 76-Year-Old Man With Macular Degeneration. JAMA. 2008;300(1):91-92. doi:10.1001/jama.300.1.91