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What Are Retinal Drusen?

Medically Reviewed by Dan Brennan, MD on June 21, 2021

‌Retinal drusen are yellow-colored spots seen under the retina of your eye that are made up of proteins and a type of fat called lipids. The retina is the layer of cells lining the inside surface of the back of your eye that sends signals to your brain and enables you to see.‌

Small drusen may not cause problems for some people, but larger drusen can increase your risk of a medical condition called age-related macular degeneration (AMD). Drusen can be a sign that you already have age-related macular degeneration. 

In age-related macular degeneration, the cells of the macula, a part of the retina, start to change because of aging. Dry macular degeneration comes first. Wet macular degeneration is an advanced form of the condition. 

Types of Retinal Drusen

‌There are two types of retinal drusen: hard and soft.

  • ‌Hard drusen are small, dotted, yellow-colored and abnormal tissue growths. When the drusen is hard, there is a lower risk of losing your vision in the future.
  • Soft drusen look large and raised, are pale yellow or grayish-white colored, and have a dome shape. There is a higher risk of losing vision in the future if you have many large or medium-sized soft drusen. 

Causes of Retinal Drusen

‌Retinal drusen can occur as a result of aging. It is common to see drusen in people over 60 years of age. 90% of drusen are caused by dry macular degeneration. The remaining 10% of drusen are caused by wet macular degeneration.‌

In dry macular degeneration, your central vision becomes blurry or lessens because of the thinning of the part of your retina called the macula. Dry macular degeneration can cause you to lose vision slowly over time. ‌

In wet macular degeneration, your vision gets blurred or you may see a blind spot in your field of vision. This condition is caused by abnormal blood vessels that break, bleed, or leak fluid into the macula and may cause sudden and severe loss of vision.

Symptoms

‌Sometimes you may have retinal drusen and not experience any symptoms. You may not find out you have them until your doctor sees them during a routine eye exam. Having a few small drusen doesn’t mean that you have eye disease. ‌

When you have a lot of larger drusen, it can mean that you have age-related macular degeneration. You could then see the symptoms linked to age-related macular degeneration:

  • ‌Dim or cloudy vision
  • ‌Difficulty seeing when the light changes from bright to dim light
  • A blank or blurry spot in your central vision

Risk Factors

‌Retinal drusen can be commonly seen in people over 60 years of age. But other factors can increase your risk of getting this condition:

‌People of Caucasian descent have a higher risk of both retinal drusen and age-related macular degeneration.

When to See a Doctor

‌You should see a doctor or eye specialist if you experience any difficulty seeing. Get urgent medical attention if you have severe or serious loss of vision.

Treatment

‌Retinal drusen are common in people over 60 years of age.  Small drusen may not cause any difficulties at all for some people.

Vitamins: You may lose vision if your age-related macular degeneration reaches an advanced stage. If you have a lot of large and medium-sized drusen, your doctor may ask you to take AREDS2 formula vitamins, which can slow down the growth of your condition to an advanced stage by about 25%.‌

AREDS2 formula vitamins are a combination recommended by Age-Related Eye Disease Study (AREDS), a NIH clinical trial. According to the results of the study, when these vitamins are taken, they reduce the risk of getting the disease by as much as 19 % and/or reduce the risk of vision loss by 25%. The formula has Vitamin C, Vitamin E, the antioxidants lutein and zeaxanthin, and minerals zinc and copper in specific amounts.‌

Lifestyle and dietary changes: Your doctor may ask you to make lifestyle changes, such as stopping smoking. They may recommend that your diet has more vegetables, fruits, and fatty fish like salmon and mackerel. You may be asked to eat less red meat in order to lower your blood cholesterol. 

Early detection: Your doctor may ask you to monitor your vision at home if you have drusen, using a test called the Amsler Grid. If you can detect wet macular degeneration early on, your doctor may be able to help you make your vision stable or improve it with injected medication. With early detection, you can slow down complications and minimize loss of vision. 

Show Sources

SOURCES:

American Academy of Ophthalmology:  "Retina," "What Are Drusen?" 

BrightFocus Foundation: "Are You Getting What You Need From Your AREDS Supplements?" "What is the Difference Between Hard and Soft Drusen?" 

Kellogg Eye Center University of Michigan Health: "Retinal Drusen." 

Mayo Clinic: "Dry macular degeneration." 

Mayo Clinic Health System: "What to know about age-related macular degeneration." 

Surv Ophthalmol: "Drusen in age-related macular degeneration: pathogenesis, natural course, and laser photocoagulation-induced regression." 

VisionAware: "The Difference Between Wet and Dry Age-Related Macular Degeneration." 

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