Final Comments

  • SDDs are underdiagnosed and their clinical significance is often under-appreciated in clinical care
  • Presence of SDDs cause severe impairment of dark adaptation
  • Presence of SDDs in AMD significantly increases risk of progression to advanced AMD, both geographic atrophy and choroidal neovascularization
  • SDDs are not easily visible during funduscopy
  • SDDs should be actively ruled out on every patient with drusen or delayed dark adaptation by using multimodal imaging
  • Presence of SDDs warrants thorough education, closer in-office monitoring, and discussion of treatment options along the AMD journey as progression occurs