The retina can be divided into two main anatomic regions – the macula and the peripheral retina. The macula is in the center of the retina and is responsible for our fine, central, and color vision. The peripheral retina comprises over 90 percent of the retina and is responsible for our peripheral and night vision.
Although macular diseases such as age-related macular degeneration (AMD) and diabetic macular edema are more common and generally more serious, there are a number of important and sometimes dangerous conditions that can occur in the peripheral retina. For example, a retinal tear or retinal detachment can be found in the peripheral retina. Below are other conditions that your retina specialist may find while examining your peripheral retina.
Lattice degeneration describes a condition in which an area of the peripheral retina is very thin. Lattice degeneration is common and usually found in myopic (nearsighted) individuals.
Since the retina overlying lattice degeneration is thinner than normal, it can be predisposed to developing tears or holes. The tears and holes may then lead to retinal detachment in some patients. Lattice degeneration is found in 10 percent of the general population, but 40 percent of people with retinal detachments are found to have lattice degeneration in the peripheral retina.
Diagnosis and Symptoms of Lattice Degeneration
Lattice degeneration may be found on routine examination of the retina, and some patients may not experience any symptoms at all. Common symptoms may include floaters and flashing lights.
Treatment of Lattice Degeneration
Lattice degeneration associated with retinal tears is treated with a barrier laser in the office to decrease the risk of the development of retinal detachment. Patients with lattice degeneration who have symptoms of floaters and flashing lights are also generally given preventative barrier laser treatment to prevent any future progression of retinal tears or retinal detachment. If a patient has lattice degeneration but no symptoms, they are typically monitored with careful examination at least annually. Patients are advised to call immediately if they experience a sudden onset of floaters or flashing lights.
White Without Pressure
White without pressure (WWP) describes a finding that your retina doctor may see when examining the peripheral retina. WWP is found in 15-30 percent of the population and is characterized by a discrete whitish-gray area in the far peripheral retina that is bordered by a dark line. To the inexperienced observer, the area of white without pressure may initially look like a shallow retinal detachment or retinal tear, but WWP does not usually lead to problems and does not require any treatment, although observation is recommended.
Congenital Hypertrophy of the Retinal Pigment Epithelium (CHRPE)
A congenital hypertrophy of the retinal pigment epithelium (CHRPE) is a flat, pigmented spot within the outer layer of the retina at the back of the eye. This condition is covered in the congenital retina defects and ocular oncology sections of our Web site.
The choroid is a layer of blood vessels that is under the retina. Sometimes a tumor of this layer can develop and is called a choroidal nevus. A nevus does not generally cause any symptoms and can only be seen by your retina physician during a dilated eye examination.
A nevus is similar to having a mole or freckle on your skin except that it is under the retina. In the majority of cases, the nevus remains benign and does not cause any problems. However, in rare instances, a choroidal nevus may develop into a malignant melanoma. Your doctor will take a photo of the nevus and monitor its condition to make sure it does not change size, shape, or color over time.
A tumor refers to an abnormal growth of tissue. Tumors may be benign or malignant, and they may also manifest in the peripheral retina. These include choroidal nevus (see above), malignant melanoma, metastatic tumors (usually from breast, lung, or prostate cancer), hemangioma, retinoblastoma, lymphoma, adenoma, melanocytoma, and osteoma to name a few. For more information about the diagnosis and treatment of tumors, please see our section on ocular oncology.
Retina Consultants of Houston specializes in managing a full range of peripheral retinal abnormalities, and we have state-of-the-art imaging and equipment to document, follow, and if needed, provide treatment for any of these conditions.