Which characteristic is considered in the diagnosis of advanced AMD?

The diagnosis of advanced age-related macular degeneration (AMD) involves identifying specific retinal changes that signify disease progression. The presence of geographic atrophy or neovascular maculopathy is critical because these findings represent late stages of AMD. Geographic atrophy indicates the death of retinal pigment epithelium cells leading to loss of vision, while neovascular maculopathy refers to the development of new blood vessels that can leak fluid or bleed, causing further damage to the macula.

In contrast, other characteristics may not necessarily indicate advanced AMD. For instance, pigmentary changes, while common in early stages of AMD, do not imply advanced disease on their own. The absence of visual symptoms is not a defining feature of advanced AMD, as many patients can experience vision loss even in the presence of mild symptoms. Focal hyperpigmentation may be an early sign but does not indicate the advanced stage of the disease. Therefore, recognizing the presence of geographic atrophy or neovascular changes is essential for diagnosing advanced AMD.