Age Related Macular Degeneration - Cuticular Drusen

These are the fundus photographs of a 42-year-old woman with cuticular drusen (yellow and green arrows) in both eyes. Her vision was 20/50 right and 20/25 left. Cuticular drusen are histochemically similar to conventional drusen in age related macular degeneration, but the phenotype is different. A family history of age related macular degeneration is common. They appear at a younger age and are rather uniform. On fluorescein angiography thy may look like a starry sky. Over time patients may develop choroidal neovascularization or retinal pigment epithelial atrophy. In her case, no treatment was administered and she was asked to return if any changes occurred in self checks with her Amsler grid.