Drusen and macular degeneration

For those living with or at risk from AMD, they may have heard of the term drusen. Drusen is very common, particularly for people over the age of 60. Having drusen present on the retina is a common indication of a patient having signs of early age related macular degeneration (AMD). But, this isn’t something to be too concerned about.

The RNIB estimate that over 4 million people in the UK have early signs of AMD, the majority of which won’t experience sight loss. But, if you’re told that you have drusen, it's very important that you know the risk factors involved and what you can do to help protect your sight.

What exactly are drusen?

The term "drusen" originates from the German language, meaning "rock". Drusen is made up of fatty proteins (lipids) and are minute yellow or white spots found on the retina and resemble tiny fragments of debris beneath the retina's surface. Drusen is caused by a build up of unwanted materials that haven't been able to be discharged.

Can drusen cause blindness?

The potential for vision impairment is linked with both the quantity and dimensions of drusen. Individuals possessing a higher count of drusen, particularly larger ones, face a heightened risk compared to those with fewer and smaller instances, this elevates the likelihood of developing AMD.

AMD is characterised by a gradual progression, leading to the deterioration of the retina and subsequent central vision impairment. However, it is essential to note that AMD does not culminate in complete blindness.

Symptoms and diagnosis

Drusen doesn’t typically have any noticeable symptoms. In fact, most individuals remain unaware of their drusen until they are identified by an eye specialist (ophthalmologist or optometrist) during a routine eye examination.

A few small drusen are not an indication of AMD, but once larger and more drusen are observed, the optometrist or consultant is likely to recommend additional tests to ascertain the potential presence of AMD. Additionally, they might inquire about any other symptoms you may be encountering.

If your optometrist or ophthalmologist detects large drusen, they may have you use an Amsler grid to check for macular degeneration symptoms such as wavy, blurry or dark areas in your vision.

At OcuPlan we encourage eye care professionals to make their patients aware as soon as drusen starts to increase size or develop more. This is an indication of the start of AMD. It is at this stage that patients be made aware of the things they can do to help protect their vision.

What are the risk factors

Drusen develops as people age. People over the age of 60 are at the highest risk. They’re more common in women and people of Caucasian descent. There are several risk factors associated with the presence of large drusen which is closely associated with AMD, including:

Age
Smoking
Obesity
A family history to the condition
Elevated blood pressure
High levels of cholesterol in the bloodstream

How can I help to protect my vision?

You can’t prevent drusen from forming. Having some drusen is considered normal. Early diagnosis of drusen with regular eye exams can help you find out if you’ve developed AMD but not everyone with drusen will go on to develop the condition.

There is no treatment for drusen or dry AMD but the earlier you can start to adopt lifestyle changes, the better chance of slowing the progression and minimising vision loss. Here are a few consultant tips:

Keep an eye out for symptoms

Regularly monitoring your vision ( using macular degeneration symptoms tests such as Amsler Grids) and getting any changes checked out with professional eye exams will help you pick up AMD early. This is key to getting the right advice and slowing the progression of age-related eye disease.

Control your blood pressure

High blood pressure (and related high cholesterol) puts the small vessels at the back of the eye under greater strain and can restrict the flow of essential oxygen to your retinas. In both cases of AMD, hypertension can play a role, therefore taking the right medication and following a doctor’s advice to keep it under control is key to protecting your eye health.

Take regular exercise

Alongside helping to reduce the likelihood of high blood pressure, regularly elevating your heart rate will help you burn calories and avoid becoming overweight - another macular degeneration risk factor.

In the case of AMD patients, taking exercise can also help to boost your mood as well as slow down the condition’s progression. This is important if you’re dealing with the mental health effects alongside the physical symptoms of AMD.

Eat a balanced diet

Another way to keep your weight and blood pressure down is eating a diet packed with fruits and vegetables. Eating plenty of leafy greens is particularly recommended, as they contain compounds such as polyphenols, flavanols and other vitamins and minerals that protect eye cells against damage.

Supplements can also be helpful in making sure you get all the nutrients and vitamins for macular degeneration prevention or protection. For those living with or at risk of dry AMD, it has been proven that taking supplements in line with the AREDS2 formulation can help to reduce the risk of developing AMD by 25%. For personalised advice on supplements and protecting your vision, call us on 0207 173 5200 or request a free OcuPlan Info Pack from My OcuPlan.

Stop or avoid smoking

Smoking puts you and those around you up to four times more likely to develop AMD. Even having the occasional cigarette can cause damage to your eye cells, raise your blood pressure and override any other steps you take to prevent the development of symptoms. So cutting out the habit altogether is recommended.

OcuPlan was created to help provide care for those living with conditions such as AMD. It is clinically advised for people living with a long-term eye condition to be monitored by their consultant ophthalmologist at least once per year. Through OcuPlan we help patients to regularly see their consultant to receive tailored treatment advice. Click here to find out more.