Retinal Degeneration Overview

Questions and Answers

What is the primary characteristic of RPE hyperplasia?

Associated with hereditary retinopathies

Production of hyperreflective signals

Presence of distinct margins (correct)

Accompanied by retinal detachment

In the context of acquired RPE hyperplasia, what does the term 'jet black to light black' primarily describe?

The extent of choroidal involvement

The reflective properties in OCT

The size of hyperplastic lesions

The color of the pigment in RPE hyperplasia (correct)

Which clinical intervention is specifically related to the treatment of Choroiditis?

Laser retinopexy

Intravitreal injections

Surgical vitrectomy

Laser photocoagulation (correct)

What is a common result of RPE hyperplasia following an inflammatory condition?

Formation of scars Signup and view all the answers

What type of imaging might show hyperreflective signals related to choroidal conditions?

Optical coherence tomography (OCT) Signup and view all the answers

What is the characteristic arrangement of pigment irregularity in reticular degeneration?

Honeycomb or reticular Signup and view all the answers

What is the prevalence of reticular degeneration in adults over the age of 40 years?

20% of adults Signup and view all the answers

What is the typical location of reticular degeneration?

Nasal quadrants Signup and view all the answers

What is the histological characteristic of reticular degeneration?

Diminution of the choriocapillaris Signup and view all the answers

What is the appearance of pavingstone degeneration?

Solitary or multifocal round punched-out lesions Signup and view all the answers

What is the typical location of pavingstone degeneration?

Between ora and equator Signup and view all the answers

What is the frequency of bilaterality in pavingstone degeneration?

Frequently bilateral Signup and view all the answers

What is the symptomatology of pavingstone degeneration?

Benign, no symptoms Signup and view all the answers

What characterizes pavingstone degeneration in terms of its coloration?

Yellow-whitish as sclera is visible through atrophic choroid. Signup and view all the answers

Which of the following is NOT a characteristic of congenital hypertrophy of the retinal pigment epithelium (CHRPE)?

Progression always leads to malignancy. Signup and view all the answers

What is observed in the histological examination of pavingstone degeneration?

Ischemic atrophy of choriocapillaris. Signup and view all the answers

What kind of lesion is typically associated with congenital hypertrophy of RPE?

Dark or black, flat lesion. Signup and view all the answers

Which statement about pavingstone degeneration is true?

It is due to a loss of RPE and photoreceptors. Signup and view all the answers

Which of the following descriptions is true regarding the pigment in CHRPE?

It is characterized by large cells densely packed with large pigment. Signup and view all the answers

Which condition is a rare association with familial adenomatous polyposis in Gardner’s syndrome?

Congenital Hypertrophy of RPE. Signup and view all the answers

How are the borders of CHRPE lesions typically described?

Well defined. Signup and view all the answers

Study Notes

Reticular Degeneration

Characterized by irregular pigment in a honeycomb or reticular pattern.
Affects retinal pigment epithelium (RPE) near the equator.
Occurs in approximately 20% of adults over 40 years old.
Typically bilateral, affecting nasal quadrants.
Usually asymptomatic and considered benign.
Histological features include:
- Diminished choriocapillaris.
- Thickened Bruch's membrane.
- Loss of melanin granules from RPE.
- Reduction in some photoreceptor cells.
- Not all histological changes are present simultaneously.

Pavingstone (Cobblestone) Degeneration

Features solitary or multifocal round, punched-out lesions.
Lesions located between ora serrata and equator, more prevalent in inferior quadrants.
Often bilateral and increasingly common with age.
Generally benign and asymptomatic.
Appearance may be visually dramatic.
Histological characteristics include:
- Ischemic atrophy of choriocapillaris.
- Subsequent loss of RPE and photoreceptors.
Lesions appear yellow-whitish due to sclera visibility through atrophic choroid.

Congenital Hypertrophy of RPE (CHRPE)

Presents as dark or black flat lesions.
Can be unilateral, bilateral, solitary, or multifocal.
Characterized by enlarged RPE cells packed with melanin granules.
Rare association with familial adenomatous polyposis (Gardner’s syndrome).
Generally a common benign condition in which RPE cells enlarge without becoming malignant.
Borders of lesions are well-defined; patients are typically asymptomatic.
Lesions may progress but malignancy is unlikely.
Lacunae may form, presenting as small atrophic areas within the degeneration.

RPE Hyperplasia

Can result from post-inflammatory events such as uveitis, retinitis, and choroiditis.
Iatrogenic factors include procedures like laser retinopexy and laser photocoagulation.
Also associated with trauma and hereditary retinopathies.
Represents a scar-like reaction to inflammatory conditions.
Similar presentation in both congenital CHRPE and acquired RPE hyperplasia, characterized by flat lesions that vary in color from jet black to light black with distinct margins.

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Description

This quiz explores the characteristics, histological features, and prevalence of Reticular and Pavingstone (Cobblestone) Degeneration in the retina. Gain insights into how these conditions affect the retinal pigment epithelium and their implications for adults over 40 years. Test your knowledge on this important aspect of eye health.