How do confluent drusen typically appear?

Confluent drusen are characterized by the merging of multiple smaller drusen into larger, more significant areas, which typically results in the engulfing of surrounding soft and hard drusen. This blending manifests as well-defined regions that can be seen on retinal examination. These regions usually signify a more advanced stage of retinal degeneration and can be indicative of age-related macular degeneration (AMD) progression.

In contrast to the appearance of confluent drusen, small scattered dots throughout the retina usually represent individual or localized drusen that haven’t merged. Uniform thickness across the retinal surface is not representative of drusen but rather normal retinal anatomy. Abnormal pigmentation in the retinal epithelium usually refers to changes that might occur with progressive retinal diseases but is not a direct descriptor of drusen morphology. Thus, the appearance described in the correct choice accurately reflects the nature and pathological significance of confluent drusen in the context of ocular health, particularly related to AMD.