Periperal Retinal Degenerations

Question 1

What’s the incidence of lattice degeneration?

Answer 1

7-11%

Question 2

Who does Lattice degeneration affect?

Answer 2

Myopes

Question 3

What’s the association between lattice and rheg?

Answer 3

Degeneration is present in a high number of detachment patients

Question 4

What does lattice degeneration show due to what does it occur?

Answer 4

It shows thin or absent inner limiting membrane

Question 5

How are the attachments between the retina and vitreous?

Answer 5

They are strong

Question 6

Why are px’s with lattice degeneration at more risk of detachment?

Answer 6

Because the stronger attachments mean that there’s increased tension on the attachments therefore at higher risk of breaks

Question 7

Where is lattice more common?

Answer 7

Superior and temporal retina

Question 8

What are the distinguishing features of lattice?

Answer 8

Sclerosed vessels which are hardened vessels that are free from blood therefore appear white

Question 9

What causes sclerosed vessels?

Answer 9

Atrophy of retinal tissue which leads to a loss of retinal capillaries

Question 10

What do areas of lattice show?

Answer 10

Hyperpigmentation due to proliferation of RPE

Question 11

What is the management for lattice degeneration?

Answer 11

Prophylactic treatment is required but not indicated for asymptomatic px’s and referral isn’t required. The px should also be given info about sx of detachment and advised to go to casualty

Question 12

What is the management for lattice degeneration when the px is symptomatic?

Answer 12

They need to be referred as an emergency because of the increase risk of break and detachment which may need referral to see

Question 13

What does snail track degeneration look like?

Answer 13

White frost like dots

Question 14

Who is more at risk of snail track?

Answer 14

Young myopes

Question 15

Does snail track increase the risk or rheg?

Answer 15

Yes

Question 16

Explain the appearance of white without pressure

Answer 16

Milky white grey appearance of peripheral retina without scleral indentation

Question 17

What can white without pressure be confused with?

Answer 17

Retinal detachment

Question 18

How can you distinguish retinal detachment and white without pressure?

Answer 18

White without pressure is clearly separated from the retina

Question 19

What does the grey white colour represent?

Answer 19

Areas of unusually strong attachment of vit and retina

Question 20

Is the px at risk of retinal detachment with white without pressure?

Answer 20

Yes but not as much as lattice and snail track

Question 21

Describe paving stone features

Answer 21

Discrete yellow patches with clearly defined borders which are pigmented

Question 22

What do the patches on paving stone represent?

Answer 22

Areas of atrophy of the retina and the choroid which allows the sclera to shine through and choriodal vessels may be visible also

Question 23

Explain the incidence of paving stone

Answer 23

It’s fairly common and found in to up to 10% and is more common in myopes

Question 24

Where does paving stone generally occur?

Answer 24

Inferiorly

Question 25

Does paving stone have a risk of retinal detachment?

Answer 25

No it’s benign and needs no treatment

Question 26

Describe microcystoid degeneration

Answer 26

Development of coalescent vesicles which give the retina a translucent and thickened look

Question 27

Explain the incidence of microcystoid

Answer 27

Increases with age

Question 28

Where does microcystoid generally occur?

Answer 28

Far periphery

Question 29

Does microcystoid increase the risk of detachment?

Answer 29

No

Question 30

Describe honeycomb degeneration?

Answer 30

Fine lines looking like a honeycomb of pigment

Question 31

Who is honeycomb generally found in?

Answer 31

Older adults

Question 32

Does honeycomb increase the risk of detachment?

Answer 32

No

Question 33

Where does honeycomb generally appear?

Answer 33

Superior nasal

Question 34

Describe asteroid hyalosis

Answer 34

Pale yellow/white lesions in the vitreous that move and float with the eye movements

Question 35

Are both eyes affected in asteroid hyalosis?

Answer 35

No only one eye

Question 36

What’s the incidence of asteroid hyalosis?

Answer 36

75% and more common in elderly px

Question 37

Are there any sx with asteroid hyalosis?

Answer 37

No

Question 38

What is asteroid hyalosis made of?

Answer 38

Lipid and calcium

Question 39

Is there any treatment for asteroid hyalosis?

Answer 39

No

Question 40

Explain what retinoschisis is:

Answer 40

It describes a split within the layers of the retina due to aggregation of microcysts in the retina

Question 41

Does retinoschisis occur gradually or suddenly?

Answer 41

Gradually

Question 42

Which layer does the split of the retina occur in?

Answer 42

Outer plexiform layer

Question 43

What happens in retinoschisis when the layers have been severed?

Answer 43

It severs the connections between the photoreceptors and the ganglion cell layer and visual function is lost in that area

Question 44

What is the incidence of retinoschisis?

Answer 44

5-7%

Question 45

Does retinoschisis affect one eye or both?

Answer 45

Both

Question 46

Who is retinoschisis more common in?

Answer 46

Hyperopes

Question 47

Do patients have symptoms with retinoschisis?

Answer 47

No, it’s asymptomatic

Question 48

How does retinoschisis appear?

Answer 48

As a smooth dome shaped elevation in the periphery

Question 49

Which layers in retinoschisis are elevated?

Answer 49

Only the neurosensory retina layers

Question 50

How do the regions that have undergone retinoschisis appear?

Answer 50

They are semi transparent with a washed out appearance and the fully detached retina becomes opaque