Microcystoid Degeneration and Retinoschisis Quiz

Questions and Answers

What is the characteristic location of the reticular type of microcystoid degeneration?

In the outer plexiform layer (OPL) and inner nuclear layer (INL)

In the photoreceptor layer, near the ora serrata

At the level of the nerve fiber layer (NFL), more superficially (correct)

In the retinal pigment epithelium (RPE), posteriorly

What is the approximate prevalence of degenerative retinoschisis in the population above 40 years of age?

10-12%

2-4% (correct)

1-2%

5-7%

Which type of microcystoid degeneration is more common and found in most adults, increasing in severity with age?

Mixed type

Atypical type

Reticular type

Typical type (correct)

What is the characteristic appearance of the typical type of microcystoid degeneration?

Small bubbles or vacuoles near the ora serrata, with a pseudo-hole appearance Signup and view all the answers

Which of the following is a complication of microcystoid degeneration?

Degenerative retinoschisis Signup and view all the answers

What is the location of the typical type of microcystoid degeneration?

In the outer plexiform layer (OPL) and inner nuclear layer (INL) Signup and view all the answers

Which of the following is a characteristic of microcystoid degeneration?

Bilateral and symmetrical Signup and view all the answers

What is the relationship between microcystoid degeneration and retinal detachment?

Microcystoid degeneration does not predispose to retinal detachment Signup and view all the answers

What characteristic appearance does White without Pressure typically present?

White/gray appearance without indentation Signup and view all the answers

In which population is White without Pressure found, and how common is it?

Approximately 30% of the general population Signup and view all the answers

What is a noted feature of White without Pressure regarding its visibility in patients?

It is easier to see in patients with pigment due to contrast. Signup and view all the answers

What age-related factor is associated with White without Pressure?

Increased instances with age Signup and view all the answers

Which condition is among the differential diagnoses (DDx) for White without Pressure?

Subclinical Retinal Detachment (RD) Signup and view all the answers

How is White without Pressure often referred to in terms of appearance?

Dark without pressure Signup and view all the answers

What is the characteristic appearance of the surface of senile retinoschisis?

Dome-shaped and smooth Signup and view all the answers

Where is White without Pressure often located in the retina?

Between the equator and ora Signup and view all the answers

What is the significance of the remnants of Muller cells in senile retinoschisis?

They are a sign of retinal splitting Signup and view all the answers

What might be a debated etiology for White without Pressure?

Optical illusion Signup and view all the answers

What is the relationship between senile retinoschisis and retinal detachment (RD)?

Senile retinoschisis is associated with a 3% risk of RD Signup and view all the answers

What is the typical visual field defect in senile retinoschisis?

Absolute scotoma Signup and view all the answers

What is the significance of scleral indentation in the diagnosis of senile retinoschisis?

It helps to visualize the retinal split Signup and view all the answers

What is the typical appearance of the edges of the retina in senile retinoschisis?

Snowflakes are seen Signup and view all the answers

What is the typical location of the retinal split in senile retinoschisis?

In the neurosensory retina Signup and view all the answers

What is the risk of retinal detachment if there are holes in both the inner and outer layers of the retina in senile retinoschisis?

High risk Signup and view all the answers

What is a characteristic feature of senile retinoschisis?

Elevation in the outer plexiform layer Signup and view all the answers

What does the typical form of senile retinoschisis involve?

Split in the outer plexiform layer Signup and view all the answers

Which quadrant is commonly associated with senile retinoschisis?

Inferior temporal quadrant Signup and view all the answers

How are the white snowflakes in senile retinoschisis described?

White dots from muller cell breaches Signup and view all the answers

What is the mobility characteristic of the bullous dome-shaped lesion in senile retinoschisis?

Immobile with eye movement Signup and view all the answers

What is the role of high axial myopia in senile retinoschisis?

It is a common contributing factor Signup and view all the answers

What does a split in the nerve fiber layer in the reticular form of retinoschisis indicate?

Less common complication of retinoschisis Signup and view all the answers

What is the appearance of the retina in senile retinoschisis when microcystoid lesions become continuous?

Subtle elevation in the retina Signup and view all the answers

Study Notes

Microcystoid Degeneration

Typical type is the most common degenerative lesion found in adults, increases in severity with age.
Characterized by small bubbles or vacuoles near the ora serrata, creating a pseudo-hole appearance.
Lesions are primarily bilateral and symmetrical, often located in the outer plexiform layer (OPL) and inner nuclear layer (INL).
More prevalent in the temporal and superior quadrants of the retina.
Reticular type is less common, featuring cysts located in the nerve fiber layer (NFL) and often more posterior than the typical type.
Typically benign with potential for progression to degenerative retinoschisis.
Does not predispose patients to retinal detachment, making it a relatively uncommon lesion.

Degenerative Retinoschisis

Affects approximately 2-4% of the population over 40 years old.
Characterized by a split in the neural sensory retina, with bilateral presentations commonly observed in the inferior and temporal quadrants.
Remains immobile during eye movement and is often asymptomatic.
Often seen in patients with high axial myopia.
Can manifest as bullous dome-shaped lesions resulting from microcystoid degeneration.

Senile Retinoschisis

Commonly presents as a split in the outer plexiform layer, noted for white "snowflake" remnants where Müller cells breach the retinal splits.
Includes both typical and reticular forms, with differences in location relative to layers and appearance.
Typical form results in split visible in the OPL, while reticular form shows pronounced elevation in the nerve fiber layer.
Diagnosed through scleral indentation or optical coherence tomography (OCT), which aids in visualizing splits and elevations.

Complications of Senile Retinoschisis

Associated with absolute visual field defects and potential enlargement to involve the posterior pole.
About 3% of retinoschisis cases may progress to retinal detachment.
Development of retinal detachment is more likely if holes are present in both inner and outer layers, occasionally necessitating surgical intervention.

White Without Pressure (WWP)

A distinctive presentation found in approximately 30% of the general population, typically bilateral and located in the temporal periphery of the retina.
Appears as a white/gray patch, often easy to detect against pigmented backgrounds due to contrast.
Size, shape, and location can change over time and can be associated with other retinal degeneration phenomena.
Differential diagnoses include subclinical retinal detachment and retinoschisis, distinguished by their appearance and bounded lines.

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Description

Test your knowledge on microcystoid degeneration and retinoschisis. This quiz covers characteristic locations, prevalence, and complications related to these degenerative conditions, particularly in individuals over 40 years old. Understand the types and appearances of microcystoid degeneration as you delve into this specialized topic.