What are the other Names for this Condition? (Also known as/Synonyms)

• Drusen Spots
• Drusenoid Deposits
• Yellowish Retinal Deposits

What is Drusen? (Definition/Background Information)

• Drusen are small yellowish (fat) deposits that accumulate around the retina. The presence of Drusen without any associated complications does not require any treatment. However, Drusen may be indicative of an increased risk for age-related macular degeneration (AMD)
• Drusen may be small or large; they may also be soft or hard. They are found (accumulate) as a normal part of aging in the retina; most adults have them. Sometimes, they may be found in the optic nerve; such cases are commonly observed in children
• Large Drusen in the retina may cause central vision loss if it is associated with age-related macular degeneration. Optic nerve Drusen may mildly affect the peripheral vision, occasionally in children

Drusen are classified based on various characteristics, particularly their size, appearance, and location within the retina. The classification helps ophthalmologists assess the risk and progression of certain eye conditions, primarily AMD. Here are the common classifications:

• Size:
  • Small Drusen: Typically, less than 63 micrometers in diameter
  • Intermediate Drusen: Ranging from 63 to 124 micrometers in diameter
  • Large Drusen: Equal to or greater than 125 micrometers in diameter
• Appearance:
  • Hard Drusen: Small, discrete, and sharply defined deposits
  • Soft Drusen: Larger, more diffuse, and less well-defined deposits. Soft drusen are often associated with a higher risk of progression to advanced AMD
• Location:
  • Subretinal Drusenoid Deposits (SDD): These are deposits located beneath the retina and are often associated with an increased risk of developing advanced AMD
• Other characteristics:
  • Cuticular Drusen: Also known as Basal Laminar Drusen, these are specific types of drusen associated with a higher risk of AMD
  • Pseudodrusen: Deposits that resemble Drusen but are located above the retinal pigment epithelium (RPE). They are associated with certain retinal conditions

Understanding the classification of Drusen is essential in assessing the risk of progression to advanced stages of AMD, guiding treatment decisions, and monitoring retinal health.

Who gets Drusen? (Age and Sex Distribution)

• Drusen may be observed in both children and adults. Adults over the age of 60 years are commonly affected by (retinal) Drusen
• Both males and females may be affected, although many cases are reported in women
• Worldwide, individuals of all racial and ethnic groups may be affected. Some studies show an increased risk for Caucasians

What are the Risk Factors for Drusen? (Predisposing Factors)

The following risk factors are noted for Drusen:

• Advancing age: Elderly adults over the age of 60-65 years. The most critical risk factor for hard Drusen is increasing age
• Use of tobacco (cigarette smoking)
• Individuals with particular genotypes, such as the complement factor H Y402H variant
• A positive family history of age-related macular degeneration
• Cardiovascular disease (CVD)
• Abnormal levels of cholesterol in the body

It is important to note that having a risk factor does not mean one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Drusen? (Etiology)

• The exact cause of the development of Drusen is not well understood. In a majority of cases, it develops as individuals age
• Drusen are yellow (fat) deposits that occur between apical retinal pigment epithelium (RPE) and Bruch’s membrane

What are the Signs and Symptoms of Drusen?

In many cases, Drusen is typically asymptomatic, and in isolation, “Drusen” findings are insignificant.

• Hard Drusen in the retina increases central vision loss, particularly if it is associated with age-related macular degeneration
• Drusen in the optic nerve can occasionally cause a mild loss of peripheral vision. Rarely, some experience dull vision (graying of vision) or flashes in the eye

How is Drusen Diagnosed?

A diagnosis of Drusen is based on the clinical findings of a fundoscopic exam. Additionally, the following observations and tests may be performed:

• Physical examination and medical history evaluation
• Assessment of signs and symptoms
• General eye exam
• Fundoscopic (ophthalmoscopic) examination by an eye specialist who examines the back part of the eye (or the fundus)
• Visual acuity test using a unique and standardized test chart (Snellen chart)
• Slit-lamp examination
• Gonioscopy, a painless eye exam using special devices
• Visual evoked potential (VEP) test
• Ocular ultrasound studies

Optic nerve Drusen may be rarely confused for an optic nerve papilledema, which may potentially hint at certain underlying conditions such as meningitis or brain trauma.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Drusen?

The complications of Drusen may include:

• Emotional stress in some individuals (following a diagnosis of Drusen)
• Increased risk for age-related macular degeneration, which may cause severe vision loss if left untreated

How is Drusen Treated?

• The management of Drusen mainly includes closely monitoring the patient to detect the development of age-related macular degeneration (AMD)
• AMD requires treatment that may include the use of dietary supplements, a healthy lifestyle, medications, and laser therapy

How can Drusen be Prevented?

• Currently, there are no specific methods or guidelines to prevent Drusen
• However, it is worth noting that the presence of certain types or sizes of Drusen may increase the risk of developing vision-threatening complications, and regular eye examinations are crucial for early detection and management

What is the Prognosis of Drusen? (Outcomes/Resolutions)

• The development of complications, such as age-related macular degeneration, in Drusen may adversely affect the prognosis
• Individuals with significant Drusen (as evaluated by an eye expert) are especially recommended to undertake regular (annual) eye exams

Additional and Relevant Useful Information for Drusen:

Please visit our Eye & Vision Health Center for more physician-approved health information:

https://www.dovemed.com/diseases-conditions/macular-degeneration