Dry macular degeneration is diagnosed by your eye care provider based on a dilated examination of your retina. A number of characteristic findings can be seen. These include drusen, changes in the layer underneath the retina (pigmentary changes in the retinal pigment epithelium), and occasional blisterlike ele-vations of the retina. Drusen, which are described in the following question, are yellow deposits underneath the retina. They may be of varying size, shape, and consistency. The pigment changes in the layer underneath the retina consist of pigment clumping and pigment atrophy.
These often give a salt-and-pepper–type appearance to the retina. The blisterlike elevations, called pigment epithelial detachments, can be noted on retinal examination, but often further diagnostic imaging is required to confirm their presence and to ensure that they are not associated with wet macular degeneration. Upon diagnosis, your eye care provider will often have photographs taken of your eye to document the current findings. Occasionally, it may be important to differentiate dry from wet macular degeneration.
This may require a dye test called a fluorescein angiogram (FA). The angiogram is helpful in demonstrating leakage from wet macular degeneration. Another helpful test is optical coherence tomography (OCT) . This test often shows fluid in the retina, another indication of wet macular degeneration. In more difficult cases, a second dye test called indo-cyanine green (ICG), which shows somewhat different characteristics of the retina, may be ordered as well. It is often helpful for you and your family to review these findings with your ophthalmologist.