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Pigmented lattice degeneration7/1/2023 ![]() ![]() Recently, some authors have reported SD-OCT imaging findings with SD-OCT of lattice degeneration, white without pressure, retinoschisis, and normative data for peripheral retinal thickness. These modalities may not fully capture the accurate structural relationship between vitreous and retina in vivo. Most of the current knowledge about these peripheral entities is based on biomicroscopy, histopathological examination, and electron microscopy. Similar to how spectral domain optical coherence tomography (SD-OCT) has advanced the interpretation of posterior pole pathology, SD-OCT may be a valuable method for evaluating peripheral vitreoretinal interface abnormalities. More recently, wide-field fundus photography has become available and may be useful in detecting peripheral retinal pathology. Documentation of peripheral retinal pathology is typically limited to indirect ophthalmoscopy and fundus photography. Most of the current approaches to clinical management are based on indirect ophthalmoscopic interpretation. Asymptomatic retinal breaks may lead to chronic inferior retinal detachment and may occasionally be difficult to distinguish from retinoschisis. Findings such as lattice degeneration, white without pressure, vitreoretinal traction, and posterior vitreous detachment- (PVD-) associated retinal breaks are common reasons for the need to treat with retinopexy in order to prevent retinal detachment. Peripheral vitreoretinal interface abnormalities span a range of entities from incidental ophthalmoscopic findings to retinal detachment. ![]() This imaging modality is useful in the clinical management of suspected retinal breaks identified with indirect ophthalmoscopy. Peripheral SD-OCT is a reliable and useful technique to examine the structural features of vitreoretinal interface abnormalities in vivo. Two cases of previously diagnosed operculated holes were found on SD-OCT to be partial-thickness operculated breaks or focal operculated schisis. Decision to treat was altered following SD-OCT in 5% of the patients. Mean age was 41 ± 22 years, and mean follow-up was 14 ± 1.6 months. Acceptable image quality for inclusion was obtained in 39/43 (91%) patients. Laser retinopexy was performed to surround all retinal breaks containing a full-thickness component via SD-OCT. SD-OCT was evaluated for image quality and structural findings. A prospective imaging analysis of 43 patients with peripheral vitreoretinal interface abnormalities seen on binocular indirect examination with scleral indentation was done. May be an incidental finding, as in this case, or seen with hereditary vitreoretinal degenerations such as Stickler syndrome in which there is a high risk for rhegmatogenous retinal detachment.The objective of this study is to describe the clinical utility and morphologic characteristics of peripheral vitreoretinal interface abnormalities with spectral domain optical coherence tomography (SD-OCT).Typically seen more posteriorly along retinal vessels in comparison to traditional peripheral lattice degeneration.Lattice lesions with retinal thinning and pigmentary disturbances along retinal vessels may be referred to as radial perivascular chorioretinal degeneration.However, lattice degeneration is present in 20-40% of rhegmatogenous detachments.Lattice degeneration is seen in approximately 10% of the population, but rarely leads to rhegmatogenous retinal detachments.Histopathologically represents localized areas of inner retinal atrophy with loss of the internal limiting membrane, adherent vitreous to the edges of the lesion with an overlying pocket of liquefied vitreous, and sclerosis of the remaining retinal vessels. ![]()
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