Paving-Stone Degeneration of the Retina

Of importance in the evaluation of the peripheral fundus is a distinctive and fairly common disease process termed paving-stone degeneration of the retina. In its typical form, this condition is located between the ora serrata and the equator and is characterized by small, discrete, rounded areas of depigmentation and retinal thinning. These lesions are yellow-white in color, frequently reveal prominent underlying choroidal vessels, and often possess a pigmented margin. Occurring singly or in groups, the lesions of paving-stone degeneration not uncommonly become confluent and may even coalesce to form bands. The prominent distinguishing features of this condition undoubtedly contributed to its initial recognition by Donders more than 100 years ago. 2 A number of subsequent reports, including a meticulous analysis by Rehsteiner, 9 noted the clinical features of paving-stone degeneration and, quite recently, Wolter and Wilson 11 and Okun 8 recorded pertinent observations on its histopathology. During the past century