Whitish Outer Retinal Spots in Rhegmatogenous Retinal Detachment

Ophthalmol Retina. 2018 May;2(5):389-395. doi: 10.1016/j.oret.2017.10.020. Epub 2017 Dec 12.

Abstract

Purpose: To characterize the whitish outer retinal spots that are occasionally present in rhegmatogenous retinal detachment (RRD).

Design: Retrospective series.

Participants: Patients who presented to Bascom Palmer Eye Institute or the University of Iowa with RRD and whitish outer retinal spots in some areas of detached retina.

Methods: Four patients who underwent clinical examination for evaluation of RRD and were found to have whitish outer retinal spots were identified, and records were retrospectively reviewed. Case histories or color fundus photographs and OCT images were summarized. Also, we searched the American Society of Retina Specialists Image Bank to assess the frequency of spot recognition and to identify 4 additional cases.

Main outcome measures: Clinical examination, photography, and OCT.

Results: Whitish outer retinal spots, which vary in size from punctate to approximately 100 μm, are occasionally observed clinically in well-circumscribed geographic areas of detached retina. In all 4 cases, the lesions were located between the retinal break and attached retina. The 4 American Society of Retina Specialists Image Bank cases demonstrated similar distributions. OCT imaging demonstrated hyperreflective foci co-localizing with the spots that are located in the outer photoreceptor segment layer.

Conclusions: We propose that these lesions represent a transitory stage of retinal degeneration several weeks after detachment. Clinical observation of whitish outer retinal spots may assist in dating an RRD as subacute and may help to identify the associated retinal break.