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my name is Glen you I'm an associate professor of Ophthalmology at the University of California Davis health I present here a 40 year old woman who is referred to us for a possible diagnosis of age-related macular degeneration as the name suggests eight related macular degeneration is a degenerative eye disease of the elderly so a diagnosis like this and a middle-aged woman would be very atypical on the clinical examination her fundus showed a large number of yellowish spots this can be seen in the magnified view in the lower left here we see optical coherence tomography which is similar to an ultrasound but uses light waves instead of sound to generate the cross-sectional image we can see that these deposits appear as dome-shaped lumps underneath the retina these lesions are known as drusen which is the German word for geodes due to their crystalline appearance they are indeed a common feature of macular degeneration however the lesions in this patient are primarily located in the pe...