Do Drusen Diagonse Macular Degeneration?

Gene Therapy Cures Blindness
Gene Therapy Prevents Blindness
November 3, 2017
Symptoms of Macular Degeneration | Randall Wong MD Retina Specialist
Signs and Symptoms of Macular Degeneration
February 27, 2018
Show all

Do Drusen Diagonse Macular Degeneration?

Drusen and Macular Degeneration

The simply answer is, no, not all patients with drusen have macular degeneration. Drusen can be associated with macular degeneration, but are not diagnostic of the disease.

In other words, a person can have drusen AND macular degeneration which means that the two conditions are associated because they can occur together, but the presence of drusen by themselves without other signs or symptoms does not mean macular degeneration is going to occur or is in the process of occurring.

What are Drusen?

Drusen are spots (lesions) that form in the layers of the retina. There are two types and can be “hard” or “soft.” based upon appearance.   The presence of a few small drusen is normal with advancing age.

Drusen can be found anywhere in the retina.  When they are located outside the macula, they are usually of no consequence and are not related to any disease, especially macular degeneration.  I am only concerned when they are located within the macula.

Unfortunately, most non-retina doctors do not mention that drusen away from the macula are of little consequence and can simply be a family trait.

When Should Macular Degeneration be Diagnosed?

Let’s take the scenario of a patient having only hard drusen and no other signs of macular degeneration such as pigment changes, fluid, or blood.

Is there vision loss?  If there is vision loss, the next thing I do is determine if there are reasons for it other than macular degeneration, such as cataracts.

When a patient has no vision loss or a loss of vision that is explained by something such as cataracts, I do not necessarily diagnose macular degeneration.

I know that many doctors DO diagnose macular degeneration every time they see drusen, and in my opinion, this is not correct or fair. Unnecessarily pronouncing this diagnosis to patients causes many people worry, anguish, and stress as they wait to go blind from a disease they do not have.

Best Test for Macular Degeneration Diagnosis

If there is any question about the diagnosis of macular degeneration, have your doctor order a fluorescein angiogram.

A fluorescein angiogram (FA) is the best test for a definitive diagnosis of  macular degeneration (ARMD).  The test is performed by a retinal specialist and each eye is injected with a dye (not iodine based) called fluorescein.  As the fluorescein dye travels through the retinas, pictures are taken which help the retinal specialist diagnose or rule out macular degeneration.

In cases of a positive diagnosis for macular degeneration, a fluorescein angiogram will also distinguish between wet ARMD and dry ARMD, so that the proper treatments can be undertaken as soon as possible.

All the best,

Randall Wong, M.D.
Retina Specialist
Fairfax, Virginia 22030

Comments
  • Aldous Cana August 16, 2018 at 11:13 am

    Hi doctor. I am 42 years old, just 2 or 3 days ago I noticed that when i looked into the cables supporting a transmitter tower, the cables tend to curve. And when i looked into the Amsler grid, I saw a very slight distortion on the left part of the grid when I look at it using my right eye. Currently I don’t have the means for an Ophthalmologist as medical consultations are expensive here in the Philippines. I can still read this page without glasses and without difficulties, but having difficulties reading messages, web pages on my smartphone. I have been using PC for the last 7 months or so. In your opinion, does my symptoms have a higher chance to be an ARMD? Do other eye diseases and ARMD have similar symtoms just distorted vision in Amsler grid? Your answers is highly appreciated. Thank you and God bless.

    • Randall Wong, M.D. September 23, 2018 at 11:13 am

      Aldous,

      I can only recommend that any one with your symptoms get an eye exam very soon.

      Randy

  • Post a comment