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Macular Drusen
by archie
(glasgow)
Hi leslie,
My wife of 49 years was diagnosed with soft drusen in both eyes 18 months ago.her sight is still 20/20 vision with glases on.
Her opthamologist has not told her what type of md she has (dry or wet) .
She sees him every 6 months .
Why has he not recommended a fluorescein test or is he just being really cautious.and why has he scared my wife with this diagnosis when there is no sight loss yet and there might never be.
Surely there must be people out there with soft drusen in both eyes and no diagnosis.p.s great site.
Reply
Thanks Archie for your e-mail. Macular drusen are often the first symptom of macular degeneration. They are small yellow deposits that have built up in the macula.
Although your wife's vision has not changed, it is important that she does take steps now with her diet and lifestyle to help prevent any progression or changes in the size and number of drusen.
To learn more about macular drusen and the difference between soft and hard drusen click here:
Macular Drusen
Kind Regards,
Leslie Degner,RN,BSN
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Macular Drusen and the Immune System
by Elizabeth
(Philadelphia, PA USA)
Why doesn't our immune system naturally eliminate drusen from the retina?
Answer
I love this question, Elizabeth, because it gives me a chance to explain that the development of macular degeneration is more of a transportation problem than it is an immune system problem.
Drusen are lumps of waste products located between the Bruch's membrand and the Retinal Pigment Epithelium (RPE).
What causes macular degeneration is actually the breakdown of this delicate transportation system - oxygen and nutrients aren't getting delivered to the macula and waste products aren't getting out.
When this system starts to break down, rod and cone cells degenerate or die.
To see a picture of macular drusen and to learn more about what size and type of drusen are the most harmful and what can be done if you have them click here:
Macular Drusen
Leslie Degner, RN, BSN
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Macular Drusen and Macular Degneration Diagnosis
by Barb
(Australia)
Can you tell me, at what stage does drusen become diagnosed as macular degeneration?
The research office I e-mailed said something like, "You do not say if you have been diagnosed with AMD." Yet I had said I have one small drusen in one eye and two in the other eye.
I know that drusen is an early indicator (or can be) of dry age related macular degeneration but when is it diagnosed as such?
eg. Is it when you have many clusters of drusen in each eye or how do they diagnose you as having dry AMD?
Answer
Drusen are not diagnostic of macular degeneration. In addition to drusen, other findings such as pigment changes (either increased or decreased pigmentation) and DECREASED vision should be present for the diagnosis of dry macular degeneration.
Age is also a consideration. I usually reserve the diagnosis for patients 55 years or older.
If a fluorescein angiogram were performed, there should be areas of RPE, or pigment, loss in the macula.
Randall V. Wong, M.D.
A Retina Specialist in Fairfax Virginia
To learn more about macular drusen go to:
Macular Drusen
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Macular Drusen in My Eyes - I'm only 42
by Kelly
(Massachusetts)
I went to the eye doctor for the first time last Nov. and he discovered I have drusen.
He said they are very small and recommended I wear sunglasses with 100% UV protection that are polarized, take eye vitamins and eat more dark leafy greens, which I'm doing.
But I'm very confused - each website I read on this topic seems to say something different. Some say hard drusen are common at my age and don't always lead to MD; others say hard drusen eventually progress to MD but at a slower rate.
Some say inflammation causes MD - others say it is UV light. I just wind up being confused, and whenever I read about it I alternate between hope and terror.
I am petrified that I will have severe vision loss within the next few years. I never thought I would have to worry about this at my age! Any clarification you could give me would be helpful.
Much thanks!
REPLY
Hi Kelly,
I am glad to hear that you are working at changing your diet and learning more about what you can do to be proactive about your vision. Now is the time to do it. There is some truth to all of the above statements.
There are two types of macular drusen - hard and soft.
The hard form is the less harmful one and very commonly seen in aging eyes.
The soft form is larger and characterized by ill-defined borders. The soft form is more often associated with loss of vision. However, when there is drusen, it does mean that process of elimination of waste is not working as effectively as it should. Waste products are building up and not being removed which results in these yellow deposits known as drusen.
Eating lots of kale, collard greens and spinach is a good place to start but there is so much more to a macular degeneration diet.
Chronic inflammation plays a key role in many degenerative diseases including macular degeneration. An anti-inflammatory diet is key in reducing chronic inflammation.
Kind Regards,
Leslie Degner, RN, BSN
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Drusen
by Pamela
(Madison,Wi)
I am confused. I am 32 years old and saw a doctor of optometry.
They took pictures of both eyes and she told me that I have soft drusen in both eyes.
She told me to come back every six months and take AREDS vitamins everyday.
She didn't give me much information so my physician sent me to a ophthamologist. She took a close look into my eyes while dilated and told me that I do have drusen in both eyes but she says it is hard.
The drusen is not in my macula. So she is sending me to a retina doctor to see if it is familial drusen.
Why do both doctors tell me the complete opposite thing? And which one do I listen to?
REPLY
Dear Pamela,
Regardless of whom you believe, it seems as if the drusen are located outside of the macula. It doesn't really matter if they are soft or hard...they are outside your macula.
A retina specialist would be able to confirm the above, but I think you are safe.
Most non-retina specialists, such as your optometrist and ophthalmologist, have your best interests at heart, but let me assure you, neither understands retinal disease...thus the confusion on your end.
I wrote an article about normal drusen and hope this can help.
If you have any questions, please write back.
Randall V. Wong, M.D.
Dr. Wong is a Retina Specialist in Fairfax Virginia
Retina Specialist
Fairfax Virginia
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, has written a nice overview of research that has been done regarding cholesterol, statin drugs and macular degeneration. Click here to read it: