Retinal Drusen

What is it?

Yellow-white flecks (retinal drusen) scattered around macular region; these are "tombstones" of dead retinal pigment epithelium
Cause is often age-related macular degeneration, poorly understood disorder of aging
Dry form of age-related macular degeneration makes up 90% of cases, consisting of drusen and atrophic pigment epithelium
Wet form of age-related macular degeneration makes up 10% of cases, consisting of choroidal vessels burrowing into retina to cause bleeding

Dry form displays yellow-white flecks and sometimes chorioretinal atrophy
Wet form displays reddish-blue mound at fovea made up of deep hemorrhage and scarring

If vision loss has been mild or only slowly progressive, refer to ophthalmologist non-urgently
If vision loss has been severe or acute, refer to ophthalmologist urgently

Dry form causes slowly progressive visual acuity loss
National Eye Institute (NEI) study found that patients with "moderate" or "severe" disease (large, confluent drusen) could have progression slowed by taking vitamin C and E, zinc, and copper available in commercial formulations
NEI study also found smoking adversely affects progression
NEI study underway to test other anti-oxidants
Wet form causes sudden and often devastating vision loss
Periodic anti-vascular endothelial growth factor (VEGF) intravitreal injections have been dramatically successful in reducing progression of wet form, especially if caught early