Introduction
The innermost portion of the human eye has a specific layer called the retina which encompasses specialized cells called photoreceptor cells. These cells are responsible for grabbing light and thereby facilitating vision. Any disturbance or interference in the retinal area can impact a person's eyesight. Drusen bodies are one of a kind which occasionally precipitates age-induced eye issues.
What Are Drusen Bodies?
Drusen bodies gather certain bodily materials like lipids (fats) and amino acids (proteins). In addition, it also contains leftover remain of cells (cellular debris). Drusen bodies are typically seen in the cellular covering of the retina. These bodies are routinely encountered in the elderly population group. However, only a small fraction of the population develops visual troubles from drusen bodies. Recent studies have concluded the association of Drusen bodies with age-related eye disorders like age-related macular degeneration (AMD), where the patient encounters trouble seeing objects clearly and distinctly. Even though the presence of drusen does not necessitate the development of age-related eye issues, the probability of developing such issues will be notably higher in individuals with drusen bodies in the retina. Thus drusen bodies expose an individual to age-related eye issues.
What Is Age-Related Macular Degeneration?
Age-related macular degeneration (AMD) is a widely reported ophthalmic issue where the person encounters trouble with vision upon aging. The middle area of the retina (macula) is responsible for central vision, which enables one to see objects lying in a straight line of view. As age advances, the macula undergoes cellular destruction and becomes filmy and slender. The presence of drusen bodies in the macula enhances this destruction and eventually precipitates a peculiar form of AMD - dry age-related macular degeneration. Another variant of AMD is wet age-related macular degeneration, where the retina gets invaded by atypical blood vessels. Dry AMD notably impacts the central (straight) vision, and over time it can advance into the wet form, which is quite dangerous and necessitates prompt medical attention.
What Leads to the Formation of Drusen Bodies?
Aging is considered to be the triggering factor for drusen formation. However, the precise mechanism that precipitates these forms of agglomerates in the retina is unclear and still under discussion. One of the extensively accepted hypotheses suggests that aging alters the retina's biochemical (enzyme activity) processes. As a result, the cells within the retina elicit alterations in the degenerative (destruction) process. These alterations induce the formation of cholesterol (fat) droplets, into which specific minerals containing calcium salts (hydroxyapatite) get attached, forming a layer. The mineral layer enhances the binding of specific proteins like vitronectin, amyloid beta, and apolipoproteins into the fat aggregates, eventually giving rise to drusen bodies.
What Are the Different Types of Drusen Bodies?
Drusen bodies can be grossly categorized into different groups considering the size of the bodies, the site of appearance, and the nature of the bodies.
1. Based on the Size and Nature of the Drusen Bodies: Considering the size of the agglomerates, it can be either small drusen or large drusen. Small drusen are the most widely reported and often firm and dense. It remains unnoticed without obvious visual disturbances; however, the deposits appear distinct and defined under examination. On the other hand, large drusen are quite doughy and are less distinct. These large drusen remarkably interfere with the retinal blood flow via choroidal blood vessels. Shutting off blood and nutrient supply brings death and destruction of the retinal cells, thereby enhancing age-related changes. Certain studies reported intermediate drusen and its size ranges between large and small drusen; however, it falls under the soft drusen category.
2. Based on the Site Where Drusen Develops: In most instances, the drusen bodies develop within the retinal area and are technically known as retinal drusen bodies. However, at times drusen bodies are encountered in association with the optic nerve, known as optic nerve drusen. The aging process does not reflect these; it develops as an inborn error.
What Are the Symptoms Associated With Drusen Bodies?
Drusen bodies, as such, do not elicit any notable signs and symptoms. However, specific visual errors can be recognized once they give way to age-related macular degeneration. The person experiences a vague and indistinguishable vision. The affected individual has trouble identifying the colors, and the color often appears dim and dull. In addition, dark spots start appearing in the field of vision, compromising the visual field. Shift in the light intensity pose challenges for the person, and dim light vision will get significantly compromised.
What Are the Risk Factors for Drusen Bodies?
Certain elements remarkably magnify the likelihood of drusen formation. Some of the potential risk factors include the following:
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Older Population: As the aging process activates the drusen formations, older individuals (over 60) are more prone to develop drusen bodies when compared with the younger population group.
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Ethnicity: Certain study reports suggested that drusen bodies develop more in Caucasians (white-skinned).
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Smoking: Studies concluded that smoking accelerates age-related changes and facilitates drusen formation.
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Hypertension: A blood pressure hike significantly impacts drusen formation in the retina. In addition to hypertension, being overweight also potentially contributes to drusen.
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High Cholesterol: The more the cholesterol level in the blood, the higher the possibility of forming lipid agglomerates in the retina, eventually developing drusen.
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Familial Influence: Individuals with a history of drusen in the previous generations are more likely to develop the condition.
What Are the Treatment Interventions Available for Drusen Bodies?
The presence of drusen bodies does not necessitate treatment, and no specific treatment is endorsed for drusen eradication. However, it must be regularly tracked to prevent progression into macular degeneration. Small drusen are often identified incidentally and are pretty harmless, but it has the potential to form larger drusen. Hence the treatment strategy entails intermittent monitoring. Larger drusen with visual disparities demand AMD treatment to deal with the symptoms.
Conclusion
Drusen bodies are protein-fat precipitates seen within the eyes that can accelerate age-induced ocular changes and troubles. These bodies develop in close connection with the retina and optic nerve. Large-sized retinal deposits are specifically responsible for bringing about visual disturbances. Keeping a check on the drusen bodies aids in tackling the inception of AMD.
