Drusen are tiny yellow deposits that form beneath the retina, the light-sensitive tissue at the back of the eye. These deposits are common, especially as people age. While often harmless, their presence can sometimes indicate underlying eye conditions. Understanding drusen and their management is important for maintaining eye health.
What Are Drusen?
Drusen are small accumulations of fatty proteins and cellular debris that gather beneath the retina, specifically in the macula. The macula is the central part of the retina responsible for sharp, detailed vision. While a natural part of aging, their size and quantity can affect their significance.
Drusen are a hallmark sign of age-related macular degeneration (AMD), a common cause of vision loss in older adults. There are two main types: hard and soft drusen. Hard drusen are small, distinct, and typically less concerning, often not affecting vision or indicating a high risk of AMD progression. In contrast, soft drusen are larger, less defined, and can be a sign of AMD, carrying a higher risk for its progression.
Managing Drusen Progression
Drusen typically cannot be “removed” through direct medical intervention. Instead, managing drusen focuses on slowing their progression and reducing the risk of vision loss, particularly the development of advanced age-related macular degeneration (AMD). Treatments are usually aimed at the complications of AMD, such as abnormal blood vessel growth in wet AMD, rather than eliminating the drusen themselves.
Nutritional support plays a role in managing drusen progression. The Age-Related Eye Disease Study (AREDS) and AREDS2 formulations, containing specific vitamins and minerals, have been shown to help slow the progression to advanced AMD in individuals with intermediate AMD or advanced AMD in one eye. These supplements typically include vitamin C, vitamin E, lutein, zeaxanthin, zinc, and copper. They can help reduce the risk of advanced disease.
Lifestyle adjustments are important in influencing drusen progression and supporting overall eye health. Quitting smoking is particularly important, as smoking is a significant risk factor for AMD and its progression. Maintaining a healthy diet rich in leafy green vegetables, fruits, and omega-3 fatty acids from sources like fatty fish can also contribute to eye health. Regular exercise and managing conditions such as high blood pressure and cholesterol are also beneficial.
Ongoing Care and Monitoring
Regular, comprehensive eye exams by an eye care professional are important for individuals diagnosed with drusen. These exams allow for professional monitoring of the drusen and the overall health of the retina. Eye care professionals may use a dilated eye exam to view the retina and may also perform optical coherence tomography (OCT) scans, which provide detailed images of the retinal layers. These examinations help detect any changes or progression in the drusen.
Individuals with drusen, especially those at risk for AMD, can use an Amsler grid for self-monitoring at home. This simple grid helps detect subtle changes in central vision, such as wavy or distorted lines, or blank spots. If any changes are noticed while using the Amsler grid, promptly reporting them to an eye care professional is important. Consistent monitoring, both at home and through professional eye exams, helps in the early detection of any progression or complications, allowing for timely intervention if needed.