Drusen (of the macula) are very small yellow or white spots that appear in Bruch's membrane (one of the layers of the retina in the eye). A possible cause of drusen is that the eye is unable to eliminate some waste products from cells of the rods and cones.
Beginning essentially at birth and continuing throughout life, cells of the retinal pigment epithelium layer accumulate cell debris. The remaining damaged cells (called lipofuscin) from the oxidative stress accumulate in Bruch’s membrane and create drusen, which is the earliest visible sign of dry macular degeneration. The lipofuscin/drusen is a cluster of protein and oxidized lipids that do not degrade. It is possible that the oxidation induces inflammation that can continue to worsen the entire macular degeneration process.
Drusen are typically associated with age-related macular degeneration in people over the age of 60; however they can arise as hereditary degenerations in young people. Drusen are a risk factor for macular degeneration but having drusen does NOT mean you have macular degeneration.
Signs and Symptoms of Retinal Drusen
There are several types of drusen with different levels of risk.
- "Hard" drusen are small and scattered far apart from each other. They are round and have distinct edges. This type may not create vision problems for a long time and may not even be associated with macular degeneration.
- "Soft" drusen are larger and closer together. Their edges are slightly blurred or less distinct. When they get to that stage, there is a greater risk for developing wet macular degeneration and more severe vision loss. Soft drusen can also disrupt the layers of the retina and may lead to retinal pigment epithelium (underlying layer of the retina) detachment.
A few small hard drusen usually do not cause any symptoms or any vision loss and should simply be monitored regularly. Medical science is not totally clear on the connection between drusen and macular degeneration. However, we do know that the larger the quantity of drusen and the larger the size of the drusen the more risk there is of developing vision loss and macular degerneration.
Drusen are visible when your eye doctor performs ophthalmoscopy and looks inside your eye at the retina. The only signs of drusen for a patient are simply reduced central visual acuity.
Treatment for Drusen of the Retina
There is currently no treatment for drusen. However, people with drusen need to be monitored regularly and should take precautions to minimize their risk of developing macular degeneration by:
1. not smoking
2. wearing UV protection/sunglasses when appropriate
3. taking proper nutrition supplements
4. exercising regularly and maintaining a healthy, lean body weight
5. eating a nutritious diet, especially green leafy vegetables and fish