Reticular pigmentation and equatorial drusen are age-related, benign, peripheral retinal degenerations that are frequently seen together and have no association with retinal breaks or detachment. They are usually bilateral. While similar in appearance, equatorial drusen are not associated with the drusen that may be seen elsewhere in the fundus such as at the macula and within the optic nerve head.
Both conditions are asymptomatic.
Reticular pigmentation typically appears as irregular fishnet-like areas of hyperpigmentation in the mid-peripheral and equatorial regions of the fundus. They may assume a honeycomb pattern. The reticular configuration becomes more obvious over time. Clumps of pigment may also gather along the vessel walls.
Equatorial drusen are small, yellow and discrete, often with a surrounding cuff of pigment. These changes have been reported as being more readily observed in the nasal quadrants on the fundus.
They are common in the older age groups.
Retinitis pigmentosa; Lattice degeneration.
No treatment is required for these conditions.Review is conducted at 2-week intervals initially, with attention to symptoms, visual acuity and fields, fundoscopy, and weight loss. Subsequent review intervals are determined by the patient’s progress. Regular review and appropriate treatment may prevent permanent loss of vision.
Reticular pigmentation (honeycomb degeneration) and equatorial drusen. Some other benign peripheral retinal degenerations are also shown. Figure courtesy of Kanski JJ. Clinical Ophthalmology 5th edition, Butterworth-Heinemann, 2003