Eye Diseases 3.pdf

Irregularity in the pigment in a honeycomb or reticular arrangement Reticular Pigmentary disturbance of the RPE near the equator (Honeycomb) Degeneration...

Irregularity in the pigment in a honeycomb or reticular arrangement Reticular Pigmentary disturbance of the RPE near the equator (Honeycomb) Degeneration ~20% of adults over the age of 40 years Bilateral, nasal quadrants Asymptomatic, benign Yang, 2024 -rpe/chorioretinal degenerations -hyperpigmented line with polygon shape 58  Reticular Degeneration Yang, 2024 59  Histology Reticular Diminution of the choriocapillaris Degeneration Diffuse thickening of Bruch’s membrane Loss of melanin granules from the RPE Loss of some of the photoreceptor cells Yang, 2024 -all these changes are not seen together 60  Solitary or multifocal round punched-out lesions Located between ora and equator Pavingstone (Cobblestone) More common in inferior quadrant Degeneration Frequently bilateral Increasingly common with age Benign, no symptoms Yang, 2024 -appearance can look dramatic - 61  Pavingstone Degeneration Yang, 2024 -yellow-whitish in color bc sclera is being seen thru the atrophic choroid 62  Pavingstone Degeneration Yang, 2024 63  Histology Pavingstone Ischemic atrophy of choriocapillaris Degeneration Subsequent loss of RPE and photoreceptors Yang, 2024 64  Congenital (CHRPE) or degenerative change in periphery with age Dark or black, flat lesion RPE Unilateral or bilateral Hypertrophy Solitary or multifocal or grouped Larger than normal RPE’s with more melanin granules Rare association with familiar adenomatous polyposis in Gardner’s syndrome Yang, 2024 -common benign lesion in which RPE cells are enlarged and with each large cell densely packed with large pigment -congenital à CHRPE -it is an outer retina change 65  Congenital Hypertrophy of RPE Yang, 2024 -borders are well defined -pt is asymptomatic -lesions can progress over time but doesn’t mean it will be malignant -lacuna à little atrophic areas within the degeneration 66  CHRPE Yang, 2024 -pigment is degenerated and lost -hyperreflective signals are noted in OCT from chroid 67  Bear Track Degeneration Yang, 2024 68  Post-inflammation Iatrogenic Uveitis Laser retinopexy Retinitis Laser photocoagulation RPE Choroiditis Trauma Hyperplasia Pigment migration Hereditary retinopathies Yang, 2024 69  RPE Hyperplasia Yang, 2024 -**scar -reaction to inflammatory condition - 70  CHRPE Acquired RPE Hyperplasia Flat Flat RPE Jet black to light black Jet black to light black Hypertrophy Distinct margins Distinct margins vs. May have lacunae May have chorioretinal atrophy adjacent to lesion Hyperplasia May have thin, clear halo No thin, clear halo Typically, round Usually very irregular May show scotoma consistent with Usually too small to produce detectable scotoma size of lesion unless in a large area of associated degeneration Usually associated with trauma or inflammatory No associated preceding event event No vitreous traction Vitreous traction may be present Yang, 2024 71