Spontaneous Bilateral Drusen Regression Without Atrophy in an Octogenarian With Gilbert’s Syndrome: A Case Report

We document significant drusen regression without atrophy (DRwoA) in a patient with dry age-related macular degeneration (AMD) and concomitant hyperbilirubinemia. Serial optical coherence tomography (OCT) and fundus images were used to monitor drusen progression in the patient. Fundus photography of the macula revealed a dramatic improvement in visible drusen in each eye over the course of 2020-2023. Only a few small drusen were visible in the right eye, while moderate to intermediate-to-large soft drusen were present in the left eye. OCT imaging also demonstrated significant improvement in drusen in both eyes compared to previous years. Average foveal thickness measurements from 2018 to 2023 showed a significant and steady decline, from 298 µm to 291 µm in the right eye and from 305 µm to 273 µm in the left eye. We report significant drusen regression in a patient with Gilbert's syndrome and dry AMD. Further investigation into the prevalence and severity of AMD in patients with Gilbert's syndrome is warranted. Additionally, further study of the potential therapeutic application of Spirulina in treating inflammatory conditions such as AMD is reasonable.