Senile macular degeneration is the most common cause of blindness in England in people over 65 years of age.1 Its cause is not known, but the clinical picture results from changes in Bruch’s membrane and the pigment epithelium of the retina. In disciform macular degeneration, severe visual loss results from new vessels growing from the choroid into the subretinal space, producing serous detachment, exudate, haemorrhage, and finally macular scarring. In the less severe ‘dry’ form, atrophy of the pigment epithelium is followed by loss of retinal receptors.
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