Lattice Degeneration Quiz
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Questions and Answers

What is one of the main purposes of scleral indentation during examination?

  • To activate retinal tears
  • To eliminate the need for optic coherence tomography
  • To view peripheral fundus in profile (correct)
  • To treat retinal breaks directly

    • Which of the following conditions is NOT a contraindication for performing scleral indentation?

  • Recent penetrating injury
  • Prior successful retinal detachment surgery (correct)
  • Recent hyphema
  • Recent intraocular surgery

    • In which patient demographic is lattice degeneration most commonly observed?

  • Patients with axial myopia (correct)
  • Patients with hyperopia
  • Patients with emmetropia
  • Patients over 60 years of age

    • What characterizes snail track degeneration in the retina?

    <p>Crisscrossing white lines and pockets of liquefied vitreous</p> Signup and view all the answers

    Which retinal condition is assessed using scleral indentation to enhance contrast?

    <p>Retinal breaks</p> Signup and view all the answers

    What is the significance of the phrase 'at the margins of the lattice degeneration'?

    <p>Indicates areas of potential retinal tear formation.</p> Signup and view all the answers

    With what condition is a high axial myopia typically associated?

    <p>Retinal breaks</p> Signup and view all the answers

    What unique feature characterizes retinal tears seen in posterior vitreous detachment?

    <p>They can sometimes resolve spontaneously.</p> Signup and view all the answers

    During a fundus examination, what is the role of optical coherence tomography (OCT)?

    <p>It assists in locating the layer of lesions in retinal degenerations.</p> Signup and view all the answers

    What describes the typical presentation of RPE hypertrophy as seen on examination?

    <p>Localized and asymptomatic in most cases.</p> Signup and view all the answers

    Which statement about scleral indentation during examinations is accurate?

    <p>It can be performed over the eyelid for better access.</p> Signup and view all the answers

    What is a distinguishing feature of pavingstone degeneration?

    <p>Presence of atrophic holes.</p> Signup and view all the answers

    What common misconception about scleral indentation might be held by students?

    <p>It can activate existing retinal tears during examination.</p> Signup and view all the answers

    Which retinal degeneration is most often described as asymptomatic and usually found bilaterally?

    <p>Lattice degeneration</p> Signup and view all the answers

    Which component is NOT included in the differential diagnosis of retinal degenerations?

    <p>Tractional retinal detachment</p> Signup and view all the answers

    What is the estimated percentage of patients with lattice degeneration who develop retinal detachment?

    <p>1%</p> Signup and view all the answers

    What is the primary mechanism by which retinal tears occur in lattice degeneration?

    <p>Posterior vitreous detachment pulling on the retina</p> Signup and view all the answers

    What is the estimated percentage of the general population that has snail track degeneration?

    <p>10%</p> Signup and view all the answers

    What is the characteristic appearance of snail track degeneration?

    <p>Groups of glistening white dots in a translucent band</p> Signup and view all the answers

    What is the primary difference between lattice degeneration and snail track degeneration?

    <p>Snail track degeneration is more common in young and myopic eyes</p> Signup and view all the answers

    What is the recommended management for high-risk patients with lattice or snail track degeneration?

    <p>Prophylactic laser intervention</p> Signup and view all the answers

    What is the characteristic appearance of laser spots after prophylactic laser intervention?

    <p>White spots that become pigmented over time</p> Signup and view all the answers

    What is the estimated risk of retinal tear or hole in patients with vitreoretinal tuft?

    <p>Low risk</p> Signup and view all the answers

    What is the characteristic appearance of vitreoretinal tuft?

    <p>Slightly elevated with a cystic appearance</p> Signup and view all the answers

    What is the recommended management for asymptomatic vitreoretinal tuft?

    <p>Observation only</p> Signup and view all the answers

    What is the primary difference between lattice degeneration and vitreoretinal tuft?

    <p>Vitreoretinal tuft is a low-risk condition</p> Signup and view all the answers

    What is the estimated percentage of retinal detachments associated with lattice degeneration?

    <p>20-30%</p> Signup and view all the answers

    What is the primary mechanism by which retinal tears occur in snail track degeneration?

    <p>Posterior vitreous detachment pulling on the retina</p> Signup and view all the answers

    What is the recommended management for patients with lattice or snail track degeneration who have a strong family history of retinal detachment?

    <p>Prophylactic laser intervention</p> Signup and view all the answers

    What is the characteristic appearance of retinal tears in lattice degeneration?

    <p>Full-thickness tears with operculum and shallow retinal detachment</p> Signup and view all the answers

    Study Notes

    Lattice Degeneration

    • Full-thickness missing retinal areas seen in OCT
    • Can be stable or very slowly progressive, with a risk of retinal tears
    • Approximately 1% of patients with lattice degeneration develop retinal detachment (RD), and ~20-30% of RDs are associated with lattice degeneration

    Complications of Lattice Degeneration

    • Retinal tears can occur with posterior vitreous detachment pulling on the retina
    • Retinal degeneration is very rare in those with lattice degeneration

    Snail Track Degeneration

    • Degeneration of neural elements leading to atrophy of tissues with lipid deposits in the inner retinal surfaces
    • Precursor of lattice degeneration
    • Resembles the slime of a snail, with holes and focal thinning similar to lattice degeneration
    • Can appreciate focal adhesions at the edges

    Snail Track Degeneration Complications

    • Similar to those of lattice degeneration, including retinal tears

    Management of Lattice and Snail Track Degeneration

    • Prophylactic laser intervention is debatable, but likely to treat high-risk patients, such as those with:
      • Fellow eye with RD
      • Strong family history of RD
      • Symptomatic retinal breaks
      • Highly myopic
      • Aphakic
      • Lattice in only seeing eye

    Laser Prophylaxis

    • White laser spots initially, becoming pigmented over time

    Vitreoretinal Tuft

    • Small foci of vitreous traction, slightly elevated, and may have a cystic appearance
    • May be surrounded by hyperplastic RPE
    • Low risk of retinal tear/hole/RD, and no treatment is required if asymptomatic

    Scleral Indentation

    • Also known as scleral depression, used to examine the peripheral fundus by displacing tissue inward
    • Enhances contrast between normal and abnormal retina
    • Indications include:
      • Signs/symptoms of RD, retinal breaks in symptomatic patients with flashes or axial myopia
      • History of blunt trauma
      • High axial myopia

    Scleral Indentation Technique

    • Can be done over the eyelid or directly on the sclera
    • Normal retina will be elevated towards the viewer when scleral indentation is applied
    • Can help identify retinal breaks and detachments

    Contraindications for Scleral Indentation

    • Recent intraocular surgery
    • Recent hyphema
    • Recent penetrating injury
    • Ruptured globe

    Peripheral Retinal Degenerations

    • Relatively common, with OCT playing a role in differential diagnosis
    • Types include:
      • Vitreoretinal degenerations (lattice degeneration, snail track degeneration, vitreoretinal tuft)
      • Intraretinal degenerations (cystoid degeneration, retinoschisis, white without pressure)
      • RPE/Chorioretinal degenerations (reticular degeneration, pavingstone degeneration)

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    Related Documents

    Scleral Indentation PDF

    Description

    Test your knowledge on Lattice Degeneration as seen in OCT images. This quiz covers key concepts, complications, and the significance of full thickness retinal areas. Perfect for students and professionals in ophthalmology and optometry.

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