Typical: occurs in all adults, may be complicated by fusion of cysts, development of cavities in the outer plexiform layer, and flat senile retinoschisis.Characteristics: yellow tiny vesicles with blurred borders on gray background.Definition: multiple small intraretinal microcystoid cavities, most frequently seen in temporal peripheral retina.Treatment: usually benign, follow patient for routine examinations.Diagnosis: OCT findings show hyporeflectivity of the ellipsoid zone.Findings: can be found posterior to area of white-without-pressure and may look like retinal tear, posterior to ora serrata.Definition: flat, brown fundus lesion with well-defined margins in the equator of peripheral retina.Complications: benign condition, not associated with retinal breaks.Incidence increases with age, no sex predilection.Prevalence: seen in around 30 to 35% of eyes examined with scleral depression.Infero-nasal quadrant least likely to be affected.Findings: retina appears normal without depression.Must be carefully distinguished from a subclinical peripheral RD.Definition: Distinctive milky white or opalescent appearance of the peripheral retina that is observed in many normal eyes when examined with scleral depression.Treatment: low risk for association with retinal detachment, so patients are examined every 1-2 years.Diagnosis: OCT shows white areas correspond to hyperreflective outer retinal layers and ellipsoid zone, no vitreous traction.Frequently causes confusion with subclinical RD and Retinoschisis but indentation clearly reveals that retina is still apposed to the RPE.Exact cause is unknown one school of thought states it to be a manifestation of peripheral vitreous traction while one believes it to be simply an abnormal reflex from a structurally normal VR interface.Characteristics: Whiter than the retina in white with pressure and the choroidal markings are almost obscured, found in post-equitorial region at the base of the vitreous and ora serrata, whiteness further accentuated with scleral depression, margins are sharply demarcated from normal retina.Prevalence: found in up to 30% of normal eyes, often bilateral, more frequently diagnosed in younger patients, may be associated with longer axial length.Definition: Distinctive white appearance of the peripheral retina without indentation and without mechanical stimulus.Treatment: should be treated when patients are symptomatic, or there is progressive retinal detachment threatening the macula.

Diagnosis: OCT findings include intraretinal hyporeflective cavities with destruction and thickening of the RPE.Primary cause of retinal detachment in 0.05-2.5% of cases.Complications: may involve posterior pole, may lead to retinal detachment.Immobile with movement of eye and produces an absolute field defect.Characteristics: Lesion is a bullous elevation of peripheral retina, found in temporal segment.Prevalence: found in 2-7% of the general population, more common in patients 40 years and older and in hyperopic eyes.Definition: senile retinoschisis (SR) is the splitting of layers of the neurosensory retina by thick fluid.Intra-Retinal Degenerations Senile Retinoschisis Therefore, OCT should be utilized in the initial diagnosis, treatment, and follow-up for peripheral retinal degenerations. Peripheral OCT may further aid in differentiation between types of peripheral retinal degeneration as well associated complications including subclinical retinal detachment, retinoschisis, retinal tears and vitreoretinal adhesions or tractions. Such detail includes the structure, shape and depth of retinal degenerations. Optical coherence tomography (OCT) has been shown to greatly benefit in the diagnosis of peripheral retinal degenerations by characterizing structural elements. Chorioretinal degenerations: paving stone degeneration and peripheral retinal drusen.Vitreoretinal degenerations: lattice degeneration, snail-track degeneration, retinal tufts, and peripheral retinal breaks.Intra-retinal Degenerations: senile retinoschisis, white-without-pressure, white-with-pressure, dark-without-pressure, peripheral cystoid degeneration, snowflake degeneration, and pearl degeneration.The following are the commonly used classifications of peripheral retinal degenerations based upon depth of retinal changes observed on optical coherence tomography (OCT): Depth of retinal changes- intraretinal, retinal, vitreoretinal, or chorioretinal.Pathomorphology- trophic, tractional, atrophic, or combined.Location- equatorial, peripheral, or combined.Peripheral retinal degenerations are classified according to the following criteria: 1 Classification of Peripheral Retinal DegenerationsĬlassification of Peripheral Retinal Degenerations.

Bear tracks retina