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Published on: September 3, 2020
Dark without pressure retinal changes in a paediatric age group
Mariana A Flores Pimentel1, Jacque L Duncan1, Alejandra G de Alba Campomanes1
1Department of Opthalmology, University of California, san Francisco, 10 Koret Way, San Francisco, CA, 94143-0730, USA.
Insights
Dark without pressure (DWP) lesions in young children share similar clinical and imaging features with adults. These outer retinal findings are benign and do not resolve, preventing unnecessary patient anxiety.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Retinal Imaging
Background:
- Dark without pressure (DWP) is a retinal finding characterized by a dark area in the mid-periphery.
- Associated imaging findings include attenuated hyperreflective outer segment bands on spectral domain OCT.
- This study focuses on DWP in young children.
Purpose of the Study:
- To describe the clinical and imaging characteristics of DWP in young children.
- To compare findings in children with those previously reported in adults.
Main Methods:
- Retrospective review of medical charts and retinal images.
- Inclusion criteria: children with DWP seen in a pediatric eye clinic.
- Imaging modalities included fundus autofluorescence and spectral domain OCT.
Main Results:
- Six children aged 3-13 years with DWP lesions were identified.
- Lesions were incidental findings, located in the mid-peripheral retina, sparing the macula.
- Imaging revealed hypoautofluorescence and reduced outer segment/EZ line reflectivity, consistent with adult findings.
Conclusions:
- DWP in young children exhibits similar characteristics to those in adults.
- The dysfunction is located in the outer retina, but the etiology remains unknown.
- Recognizing DWP as a benign condition can alleviate patient anxiety and avoid further investigations.
Background/Objectives:
We aim to describe the clinical and imaging characteristics of young children with dark without pressure- a well-defined area of dark retina in the mid periphery associated with attenuated hyperreflective outer segment bands on spectral domain OCT.
Subjects/Methods:
Retrospective medical chart review. We reviewed the charts and retinal images of children with dark without pressure (DWP) seen in the paediatric eye clinic that had undergone retinal imaging.
Results:
We identified 6 children (3 males, 3 females) ranging in age from 3 to 13 years with DWP lesions. These were an incidental finding in children referred for other disorders. The lesions spared the macula and were typically in the mid-peripheral retina. In those children who could cooperate with detailed imaging, the DWP lesions were hypoautofluorecent on fundus autofluorescence imaging and OCT imaging showed reduced reflectance of the outer segments and EZ line as has been described in older children and adults. In two of the six subjects a DWP lesion appeared in an area of previously normal fundus; in no subjects did the lesion resolve over the period of follow up.
Conclusions:
The clinical and imaging characteristics of DWP lesions are similar in young children to those described in adults. The site of dysfunction appears to be at the level of the outer retina, but the precise cause is unknown. Recognition of this benign disorder will prevent patient anxiety and unnecessary further investigation.
