Most persons older than 50 years have at least one small druse. Both forms affect the various tissue layers of the retina. However, the neovascular, exudative form results in serous or hemorrhagic detachment of retinal pigment epithelium and choroidal neovascularization. As the atrophy continues, reading vision decreases, and patients must use magnification to read. Eventually, both forms lead to irreversible loss of the ability to read, recognize faces or drive.
Most patients maintain enough peripheral vision to walk unaided.
Age-related macular degeneration. The prevalence of macular degeneration increases with age. In one population-based study, macular degeneration occurred in only 0.1 percent of persons 43 to 54 years of age but increased to 7.1 percent in persons 75 years or older. The progression of macular degeneration can be variable and quite insidious. Some patients do not notice the visual fluctuations associated with age-related macular degeneration.