Dry Macular Degeneration with Geographic Retinal Pigment Epithelial Atrophy

This fundus photograph taken from an 83 year old woman with dry macular degeneration shows drusen (black arrow), which are accumulations of metabolic waste material deposited under the retinal pigment epithelium, and geographic atrophy of the retinal pigment epithelium (outlined by blue arrows). The drusen presumably injure the overlying retinal pigment epithelial cells, which eventually die and leave an atrophic zone through which the underlying choroid can be seen more clearly (notice the large choroidal vessels in the atrophic zone).