What Are Drusen?
Last updated: March 2022
Drusen is a German word that translated means node or geode. They are yellow or white deposits of cellular waste and proteins that are not disposed of or recycled by the body. Drusen collect like pebbles under the retina between two layers of the eye called RPE (retinal pigment epithelium) and Bruch’s membrane. They generally develop in your eyes as you age. They are common in people over age 60, especially women.3
Drusen and macular degeneration
Drusen do not cause age-related macular degeneration (AMD) but the presence of some kinds of drusen indicate an increased risk of developing AMD.1 AMD is a degenerative disease that affects the retina and the clarity of your central vision.3
There are three different kinds of drusen, hard, soft, and drusen of the optic nerve.
- Hard drusen may not cause vision problems. They are small, distinct, and spaced apart.
- Soft drusen are larger and closer together. They are not distinct, and their presence can increase the risk of developing AMD.
- Sometimes drusen develop in the optic nerve. Also known as optic disc drusen, they are made up of protein and calcium salts. Optic nerve drusen generally appear in both eyes. They can develop at any age, including in children. When this happens, most people don’t experience any vision loss, but for those that do, it is the peripheral (side or edge) not the central vision that is likely to be affected.1-3
How are they diagnosed?
There are rarely presenting symptoms of drusen. They are diagnosed by an ophthalmologist during a routine eye exam with dilation. When the pupils are dilated, widened by eyedrops, the back of the eye, including the retina, can be examined. If drusen are detected, additional tests may be performed. The doctor may have you look at an Amsler grid if soft drusen are found. If you see wavy, blurry or blacked out areas, these may be symptoms of macular degeneration. If optic nerve drusen are suspected, other imaging tests may be needed to confirm the diagnosis.
Treatment for drusen
Some drusen require continuous monitoring but no treatment, including those in the optic nerve. Hard drusen are monitored over time but require no specific treatment unless they change into soft drusen. Soft drusen treatment follows an AMD protocol and the ophthalmologist or a retina specialist will prescribe the method most appropriate for you.
Risk of vision loss
As drusen increase in size and/or number, the risk of vision loss and developing age-related macular degeneration also increases.3 Regular eye exams should be performed on an annual, if not more frequent basis, as determined by your ophthalmologist, to monitor the size and location of drusen, and whether there is a measurable change in visual acuity.1-3
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