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OPTICAL COHERENCE TOMOGRAPHY IN AGE-RELATED MACULAR DEGENERATION
2. Age-Related Maculopathy
Age-related maculopathy, considered the precursor of
age-related macular degeneration (AMD), is defined as
the presence of areas of hyperpigmentation or hypopig-
mentation of the RPE and/or confluent or soft drusen.
When soft drusen in the macular region are associated
with focal areas of mobilization of pigment (hypopig-
mentation and hyperpigmentation), there is an increased
risk of progression to AMD. Drusen, which are degen-
erative nodular formations located mainly in Bruch’s
membrane, are comprised of proteins, lipids, mucopoly-
saccharides, and other components that appear in adult-
hood and tend to increase in size and number over time.
Drusen is the AMD characteristic that is detected early
in the clinical examinations. On OCT, drusen appear as
RPE deformation or thickening that may form irregu-
larities and undulations (Figure 2).
Drusen are classified histologically as hard formations
and defined as small hyaline deposits with delimited
margins that are considered age-related low-risk changes,
and soft drusen, which are deposits of granular or amor-
phous material considered to be precursors of AMD.
Drusen can progress to an atrophic form (dry) or exuda-
tive form (wet) of AMD. The risk is based on the lesion
number, size, and confluence.
4,6,8,1-15
Figure 2.
Drusen are seen as undulations and elevations in the hyperreflective band of the RPE with less reflective material be-
neath them, while the inner retinal layers remain generally intact.
