From Diagnosis to Decision – June 2023 Since Sue has not written any new journal pages for some time, the site has been archived until we can decide if the work necessary to make sure all information is accurate and up-to-date can be made. In the meantime, you'll get some pages 'not found' or 'private' until that decision has been made. The emphasis for several years has been on the Facebook group.
What are drusen? Does it mean I have AMD? Is it drusen or drusens?
QUESTION: What are drusen? Does it mean I have AMD?
Short Answer
The word ‘drusen’ is plural. One of them is ‘druse’.
Two Important Types of Cells
The retina is very complex. The macula is part of the retina. There are 2 types of cells that are central to a discussion of drusen: RPE cells (Retinal Pigment Epithelium) and the photoreceptors that turn light into sight. The RPE cells are ‘slaves’ to the ‘master’ photoreceptors. They bring the photoreceptors nourishment to keep them alive, and they remove waste materials from them (think ‘eye poop’). If the RPEs are damaged and can’t do their job, the photoreceptors don’t function well. If the RPE cells die, the photoreceptors eventually die, too. That’s when vision loss occurs.
So what exactly are drusen?
AMD is the only type of macular degeneration where drusen occur.
Drusen are a buildup of waste material (think ‘eye poop’) under the RPE cells which are the ‘slaves’ (nourish them & keep them ‘clean’) to the photoreceptors which give us sight.
If that drusen/’eye poop’ is in the macula, it CAN be a sign of AMD (not always, you’ll see that below). The significance is that it can tell the eye professional how far your AMD has progressed and what stage it is. It also weakens the cells below it which can allow the blood vessels that feed the retina to grow beyond their boundaries and become wet AMD.
Click on the image to go to the source
In the middle of the illustration, drusen are shown as a yellow ‘clump’ under the RPEs and above the blood supply in what is called the choroid. Between the choroid and the RPEs is Bruch’s membrane.
You can find a more detailed description and more illustrations on one of the best sites I’ve found: ‘The Science of AMD.’
Does having drusen mean that I have AMD?
Not necessarily. It depends first on where the drusen are located. It can be inside the macular and outside it, too. It’s the drusen in the macula that can be of concern.
Hard drusen are small and have defined edges. They are more common as we age. They don’t necessarily mean that you have AMD. Soft drusen are larger and their borders are not defined. They vary in side and shape. Your eye doctor will be able to tell what stage your AMD is by the number and size of the drusen plus some other factors).
You can find out how each stage is diagnosed on the page ‘Macular Drusen.’
