With increasing age the retinal pigment epithelium accumulates so-called ‘intracellular residual bodies’ and these patches are known as drusen.
Drusen are commonly seen in the elderly population and are often found in the macular regions.
The major classification is into soft and hard.
You will need to view the enlarged versions of the images below in order to see the drusen properly.
Soft drusen have indistinct edges and are small (often tiny).
Hard drusen have distinct margins and are larger.
Drusen in ARMD
In age-related macular degeneration (ARMD) drusen are bilateral and symmetrical.
In diabetic patients the major importance of drusen is that they are often confused with exudation. This is easily done when changes are as widespread as shown in this image.