Hard Drusen

Fundus photograph demonstrates multiple hard drusen
  • Commonly present in all ages on fundus photograph.
  • The incidence and prevalence of hard drusen is not age related.
  • Their presence alone is not sufficient to diagnose early age related maculopathy.
  • Hard drusen is not associated with increased risk for the development of choroidal neovascularization.
  • Histologically are globular deposits of hyaline material.

Clinical Features

  • Symptoms: typically asymptomatic
  • Signs:
    • Small, hard drusen has been defined as being < 64 µm in diameter
    • Discrete, yellow-white deposits that are external to RPE
    • Almost always have distinct and well-defined border
  • Fluorescein angiogram usually demonstrates pin-point window defect.