Retina-Periphery

Peripheral Senile Pigmentary Degeneration (Reticular Degeneration) SYMPTOMS Asymptomatic SIGNS Typically bilateral Found 360 degrees in the peripheral retina (typically between the ora serrata and equator) and usually more prominent nasally Net-like and granular areas of RPE pigment which are often associated with drusen WORK-UP Full eye exam with dilated retinal exam, OCT of the macula…

Congenital Hypertrophy of the Retinal Pigment Epithelium (CHRPE) SYMPTOMS Typically asymptomatic May sometimes be associated with visual field defects especially if the CHRPE is located in the posterior pole and lacunae is present SIGNS There are three types of CHRPE Solitary CHRPE: Typically unilateral. Ranges from 0.2-13mm in size (can be very large). Appears as…

Myopic Degeneration SYMPTOMS Typically asymptomatic but can experience visual field loss with involvement of the posterior pole and/or central vision loss with macula involvement SIGNS Posterior staphyloma, Lacquer cracks, Myopic conus, Tilted optic disc, Vertically elongated optic disc, Areas of chorioretinal atrophy, Fuch spot, Tessellated fundus, Large vitreous floaters, Retinal microfolds, Paravascular cysts, Myopic choroidal…

Peripheral Retinoschisis SYMPTOMS Typically asymptomatic Rarely, patient may report central vision loss if the peripheral retinoschisis involves the macula An absolute visual field defect correlating to the location of the retinoschisis will be noted SIGNS Typically unilateral (can be bilateral 30% of the time) Typically found in the inferior temporal quadrant of the peripheral retina…

Retinal Detachment SYMPTOMS Flashes, Floaters, Black curtain over vision, Relative visual field loss correlating to location of retinal detachment, Central vision loss if retinal detachment involves the macula SIGNS Rhegmatogenous retinal detachment (most common type): Elevated gray-white tissue that is opaque and wrinkled (appears as “wet tissue paper”). Gray-white tissue may appear to undulate. Other…

Retinal Tear SYMPTOMS Typically reports flashes and/or floaters but can also be asymptomatic SIGNS A red linear or horseshoe shaped lesion in the peripheral retina. Gray-white tissue will be attached to the red linear or horseshoe shaped lesion (called a flap) There may be a white-gray cuff surrounding the red lesion that represents edema or…

Retinal Hole SYMPTOMS Typically asymptomatic but may experience floaters and/or flashes SIGNS Atrophic retinal hole: A round red lesion that is anywhere from pinpoint to 2DD in size in the peripheral retina. There may be a white-gray cuff surrounding the round red lesion that represents edema or RPE pigment surrounding the round red lesion that…

Dark Without Pressure SYMPTOMS Asymptomatic SIGNS Dark area of the retina (especially when compared to the surrounding retina) with well-defined margins WORK-UP Full eye exam with dilated retinal exam, Scleral depression, Peripheral 90D, Gonioscopy 3-mirror (using retina mirrors) TREATMENT No treatment is needed and retina needs to be monitored FOLLOW-UP See patient back in 12…

White Without Pressure SYMPTOMS Asymptomatic SIGNS Typically bilateral Milky white-gray bands of retinal translucence (especially when compared to the surrounding retina) that is usually well demarcated by a posterior border that is dark red in color WORK-UP Full eye exam with dilated retinal exam, Scleral depression, Peripheral 90D, Gonioscopy 3-mirror (using retina mirrors) TREATMENT No…

Pavingstone/Cobblestone Degeneration SYMPTOMS Asymptomatic SIGNS Cobblestone degeneration: Punched out yellow-white areas that are often surrounded by pigment in the far peripheral retina. The punched out areas tend to be smaller and coalesced Pavingstone degeneration: Punched out yellow-white areas that are often surrounded by pigment in the far peripheral retina. The punched out areas tend to…