Pavingstone/Cobblestone Degeneration

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 be larger and not coalesced
WORK-UP Full eye exam with dilated retinal exam
TREATMENT No treatment is needed and retina needs to be monitored
FOLLOW-UP See patient back in 12 months
ADDITIONAL LAB | TESTS None
ETIOLOGY Outer retina and chorioretinal degeneration where there is loss of retinal tissue (especially the RPE) due to choriocapillaris occlusion
DIFFERENTIAL DX Chorioretinal scars, RPE window defect, CHRPE with complete lacunae
NOTES Pavingstone and cobblestone degeneration are typically found in the temporal, inferior nasal, inferior, and inferior temporal quadrants of the far peripheral retina
Pavingstone/Cobblestone Degeneration: Retinal photo demonstrating pavingstone degeneration https://doctorlib.info/ophthalmology/principles/59.html