Peripheral Retinal Degenerations
Peripheral retinal degenerations refer to
degenerative changes that lie parallel to the ora serrata in the peripheral
portions of the retina. These include two basic types:
❖ Harmless retinal changes such as pars plana cysts of the posterior ciliarybody or
peripheral chorioretinal atrophy (cobblestone degeneration).
❖ Precursors of retinal detachment such as local thinning of the retinareferred to as snail track
or lattice degeneration.
The prevalence of the lesions is 6 – 10%.
Unknown.
Peripheral retinal degenerations are asymptomatic.
The diagnosis is made by ophthalmoscopicexamination of the peripheral
retina with the pupil dilated. The retina may be examined by indirect binocular
ophthalmoscopy or using a three-mirror lens.
Cobblestone degenerations appear as whitish sharply defined localizedareas of extensive
atrophy of the retina, pigment epithelium, and choriocapil-laris that lie
between the ora serrata and the equator. Snail
track degenera-tion presents with yellowish, whitish radiant dots
consisting of microglia andastrocytes. Lattice
degeneration presents with thinned retinal areas with whitish sclerotic
vessels. This results in reactive focal atrophy and hypertro-
phy of the retinal pigment epithelium in the
region of equatorial degenera-tion and liquefaction of the overlying vitreous
body.
The findings are highly characteristic and easily diag-nosed
clinically. Rarely, vascular processes or inflammatory changes and scars from
other causes must be considered in a differential diagnosis.
Treatment is either not required or not recommended as
lasertherapy does not reduce the risk of retinal detachment. Ophthalmoscopic
fol-low-up examinations should be performed at regular intervals.
No prophylaxis is possible.
The clinical course is usually benign. Roundatrophic retinal
breaks can develop in the areas of snail track and lattice degeneration.
However, the long-term risk of retinal detachment is only 1%.
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