Detecting Drusen Before Macular Degeneration May Help Prevent Disease 

Like all living things, one of the cycles of life is consumption and waste. Identifying what an organism consumes to sustain life is essential when researching biological processes. Just as important is the waste generated by cellular organisms within the body and how it may affect systemic functioning. One waste product deposit accumulated under the retina which scientists have been studying for years is called drusen. 

Drusen is considered one of the major players in the formation of macular degeneration as, over time, it can create a type of plaque that compromises sight. By identifying the origins of drusen production, researchers are estimating a potential early diagnosis which could enhance targeted treatment options. 

These treatments may even include botanical medicine as well as clinical nutrition, both natural attempts at minimizing or even preventing macular degeneration manifestation altogether. Either way, this new research shows how detecting drusen before macular degeneration may help prevent disease.  

Garbage Disposal Problem 

When the body is unable to move out toxins or debris from its vast network of cellular functions, problems can occur. Drusen, which comes from the German word which means a rock or geode, is an exact example of what can happen when the accumulated buildup of debris occurs. 

Joshua Dunaief, MD, PhD of the Scheie Eye Institute, University of Pennsylvania commented on the process of drusen for a Bright Focus Foundation Macular Degeneration Research paper, stating that, 

“The cause of the drusen deposits is related to a type of “garbage” disposal problem. Retinal cells dump unwanted material, and immune cells normally cleanup most of it. However, if too much is dumped, or it is not properly packaged for disposal, or the immune cells don’t function efficiently, it can pile up. The drusen contain proteins and lipids (naturally occurring molecules that include fats). Some of the proteins are pro-inflammatory, indicating that the immune system is coating the drusen. One protein in drusen is beta amyloid, which is also found in deposits within the brains of people who have Alzheimer’s disease, and may contribute to both diseases.” 

No one knows why certain individuals have more drusen than others. It is theorized that it can be caused by anything from encoded gene sequencing to environmental influences to lack of certain nutritive variants. As research continues searching for the cause of drusen, finding early markers and applying treatment accordingly may be an essential protocol.  

Drusen Dangers 

Although it has not been completely validated that drusen causes AMD (age-related macular degeneration), the more research conducted, the more it seems that drusen could be a direct link to the disease. 

A study titled, ‘Drusen ooze: Predictor for progression of dry age-related macular degeneration’ published in Graefe’s Archive for Clinical and Experimental Ophthalmology stated and concluded, 

“The presence of drusen ooze at baseline [] significantly correlated with development of iRORA [incomplete retinal pigment epithelium and outer retinal atrophy] and cRORA [complete retinal pigment epithelium and outer retinal atrophy]. In total, 14 eyes progressed from iRORA to cRORA over a mean follow up of 29.14 (±24.33) months. Odds of progression to iRORA or cRORA were 20.3 times greater for eyes with drusen ooze at baseline. Conclusions: In dry AMD, drusen ooze is a useful sign for predicting progression to iRORA and cRORA over time.”  

This study shows the dangers of drusen formation and how being vigilant in monitoring this potential manifestation is paramount.

Early Drusen Formation Found

Researchers from the University of Colorado have revealed the results from their study of the mechanisms underlying early manifestations of AMD. 

According to the university, research shows that, 

“…retinal pigment epithelium (RPE) cells – a simple layer of cells located under the photoreceptor cells in the eye – release exosomes [a type of extracellular sac that contain protein, DNA, and RNA taken up by distant cells, where they can affect cell function and behavior] that contain both normal proteins and proteins that are associated with drusen, one of the key initial manifestations of AMD, in normal physiological conditions. Under stressful conditions, however, RPE cells release drusen-associated proteins about 20 times more, providing a potential biomarker of AMD. [This] research shows that when RPE cells are exposed to an environment similar to that leading to AMD, they respond with a dramatic increase in the release of drusen-associated proteins via exosomes.”

This is the first research that shows the potential formation of drusen in its early stages. The biomarker can be found in blood, tears, urine, or saliva and may change the treatment trajectory, 

Lead researchers of the study, Miguel Flores-Bellver, PhD, and Valeria Canto-Soler, PhD, commented,

“It opens the possibility for early diagnosis of a person developing AMD by determining that their cells are secreting a lot more exosomes with these drusen-associated proteins than in normal conditions,…Knowing that extracellular vesicles are releasing drusen-associated proteins presents an opportunity for novel [new] diagnostic and therapeutical approaches…we could think of developing new tools to target and modulate exosome release and protect the cells from the accumulation of drusen under the retina…we may be able to control the formation of drusen and slow down or even, perhaps prevent, some of the pathological events leading to AMD,”

This ‘deep dive’ into the mechanisms of AMD progression offers new hope to a generation of those potentially at risk. As this research continues, there is a chance that macular degeneration can be detected way before any symptoms appear creating preventative measures through diet and supplements as well as pharmaceuticals to stop the disease in its tracks. Supplement recommendations include the well studied supplemental protocol AREDS2 (age-related eye disease study #2) formula of antioxidant vitamins (lutein, vitamin C, vitamin E, zinc and copper). Talk to your eye doctor about detecting your drusen levels for a possible prevention protocol. 

Sources:

https://www.ophthalmologytimes.com/view/university-of-colorado-researchers-provide-evidence-linking-extracellular-vesicles-with-drusen-formation-and-age-related-macular-degeneration

https://pubmed.ncbi.nlm.nih.gov/33710471/

https://www.ophthalmologyretina.org/article/S2468-6530(21)00164-0/fulltext#relatedArticles

https://www.brightfocus.org/macular/article/why-my-doctor-always-talking-about-drusen

https://www.ophthalmologytimes.com/view/university-of-colorado-researchers-provide-evidence-linking-extracellular-vesicles-with-drusen-formation-and-age-related-macular-degeneration

https://pubmed.ncbi.nlm.nih.gov/33710471/