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Drusen, from the German word for node or geode (singular, "Druse"), are tiny yellow or white accumulations of extracellular material that build up between Bruch's membrane and the retinal pigment epithelium of the eye. The presence of a few small ("hard") drusen is normal with advancing age, and most people over 40 have some hard drusen. [1]
Optic disc drusen (ODD) are globules of mucoproteins and mucopolysaccharides that progressively calcify in the optic disc. [ 1 ] [ 2 ] They are thought to be the remnants of the axonal transport system of degenerated retinal ganglion cells .
AMD can be divided into 3 stages: early, intermediate, and late, based partially on the extent (size and number) of drusen. [1] AMD-like pathology begins with small yellow deposits (drusen) in the macula, between the retinal pigment epithelium and the underlying choroid.
Mild signs of hypertensive retinopathy can be seen quite frequently in normal people (3–14% of adult individuals aged ≥40 years), even without hypertension. [4] Hypertensive retinopathy is commonly considered a diagnostic feature of a hypertensive emergency although it is not invariably present.
If caught early, the neovascularization can be reversed with prompt panretinal photocoagulation (PRP), or injection of anti-VEGF medications with subsequent PRP. The injection blocks the direct effect of VEGF and acts more quickly but will wear off in about six weeks. [4] PRP has a slower onset of action but can last permanently.
These include general surgical procedures, cataract surgery, hemorrhagic shock, certain medications, and optic disc drusen. The exact mechanism of optic nerve ischemia in these cases remains unclear, but contributing factors may include hypotension , anemia , hypoxia , and changes in the autoregulation of optic nerve arterial blood flow.
Night blindness can be caused by a number of factors the most common of which being vitamin A deficiency. If detected early enough nyctalopia can be reversed and visual function can be regained; however; prolonged vitamin A deficiency can lead to permanent visual loss if left untreated. [55]
Xerophthalmia from hypovitaminosis A is specifically due to lack of the hormone-like vitamin A metabolite retinoic acid, since (along with certain growth-stunting effects) the condition can be reversed in vitamin A deficient rats by retinoic acid supplementation (however the retinal damage continues).