This 22YO male presented with bilateral dark without pressure, lattice lesions, and atrophic holes. He is asymptomatic, and prophylactic treatment was not recommended.
Learning Points:
White without pressure (WWP) and dark without pressure (DWP) are relatively common benign peripheral findings most commonly found in darkly pigmented individuals. Typically, there are bilateral peripheral geographic areas of whitish (WWP) or dark (DWP) retinal discoloration.
WWP gets its name because the area appears white without indentation, unlike scleral depression (white with pressure). It can sometimes be confused with retinal breaks or detachment. The exact cause of this phenomenon is unknown.
Historically, it was felt to be due to a benign vitreoretinal interface change, but more recent OCT findings show increased (WWP) or decreased (DWP) reflectivity in the outer retina (see Diaz et al, Retina 2014;34:1020-1021).
