![]() 2,3ĭrusen are also found in the periphery of normal eyes without AMD, with a few modifications in its makeup compared with degenerative macular drusen. 1,3 Later in the disease, this dysfunction is made visible clinically as drusen. ![]() This influences the diffusion of nutrients and waste products between the RPE and choroidal bloodstream, leading to dysfunction. 1 The accumulation of RPE waste products, among other types of cellular debris, results in the thickening of Bruch’s membrane and decreased permeability. 1,2 This damage is made evident as a result of continuous light exposure at the RPE/Bruch’s membrane interface and subsequent formation of reactive oxygen formation and oxidative stress.ĭrusen may also become deposited from the choroidal vasculature and systemic circulation. 1ĭrusen deposits are made up of various proteins, polysaccharides, glycosaminoglycans and lipid, amyloid and complement factors that arise from inflammatory and immune responses to RPE cell damage. 3 Despite significant advancement within the past several years in understanding the exact pathogenesis of AMD, the mechanism of drusen formation is not yet fully defined. 1 Clinically, they appear as focal, whitish yellow excrescences beneath the retina, often of variable size and number. Click image to enlarge.ĭrusen are extracellular deposits of debris and waste products that accumulate at the level of Bruch’s membrane below the retinal pigment epithelium (RPE). This patient has subretinal drusen deposits in the macular region. This discussion of the unique pathophysiology and histological changes in AMD, and how it differs from healthy, non-pathological drusen deposition, can help you differentiate the two. However, drusen are also known to occur in younger eyes without AMD. 2 Since AMD is chronic and progressive, early identification is imperative in delaying the course of the disease and referring for prompt treatment when necessary to preserve visual integrity. 1,2 This is an important clinical finding, as AMD ranks globally as the third leading cause of blindness after cataracts and glaucoma. ![]() D rusen, along with pigment mottling, are the earliest clinical signs and a characteristic hallmark of age-related macular degeneration (AMD). ![]()
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