For a study, researchers sought to assess the predictive importance and influence of the cuticular drusen phenotype on visual function in a group of people with intermediate age-related macular degeneration (AMD). Participants were at least 50 years old, had bilateral big conventional drusen, and were free of late AMD. MMI and microperimetry were conducted at the start and subsequently every six months for up to 3 years. At baseline, each eye was assessed for the existence of cuticular drusen based on MMI. To assess the occurrence of pigmentary abnormalities, color fundus pictures were employed. The drusen volume was calculated using OCT images. The relationships between cuticular drusen and progression to MMI-defined late AMD (including OCT indications of atrophy) and the influence on visual sensitivity were investigated with and without adjusting for baseline age, pigmentary abnormalities, and drusen volume. 

A total of 280 eyes from 140 participants were included in the study, with cuticular drusen present in 70 eyes from 35 people (25%). With and without adjustment for covariates, cuticular drusen were not significantly linked with a higher incidence of progression to late AMD (P≥0.784 for both). In addition, cuticular drusen were not linked with decreased baseline visual sensitivity (P=0.758) or a quicker rate of visual sensitivity loss (P=0.196) in an adjusted model.

Individuals with the cuticular drusen phenotype showed neither a greater nor a reduced risk of developing late AMD in a cohort with bilateral large conventional drusen over three years and were not linked with a difference in the rate of visual sensitivity decrease compared to those without this phenotype. As a result, individuals with this phenotype required the same monitoring measures as those with typical drusen.