[Drusen and their significance in age related macular degeneration]

In 81 patients with bilateral drusen and 150 patients with unilateral disciform lesions drusen were analyzed with respect to number, size, density and early and late angiographic behavior. In patients with bilateral drusen excellent symmetry was observed for all parameters. Drusen in fellow eyes of patients with avascular pigment epithelium detachments were larger, more confluent and less fluorescent than drusen in fellow eyes of patients with choroidal neovascularization. These results reveal drusen as products of specific metabolic failures of the pigment epithelium rather than unspecific aging changes. These metabolic failures result in specific individual patterns of drusen, which predispose to the development of specific complications of age-related macular degeneration.