Peripheral retinal degenerations: A review of peripheral optical coherence tomography applications in their diagnosis and visualization

Optical coherence tomography (OCT) has transformed retinal imaging, primarily focusing on the posterior pole; however, its application in assessing peripheral retinal lesions is an evolving field. Recent advances in widefield (WF) and ultra-widefield (UWF) OCT technology have significantly expanded the ability to image the peripheral retina, allowing for improved detection and characterization of peripheral retinal lesions. We evaluate the effectiveness of OCT in identifying peripheral retinal lesions, assessing vitreoretinal adhesions and tractions, aiding differential diagnosis, and guiding treatment strategies among studies published between 2006 and 2024. WF and UWF OCT have significantly enhanced the visualization and documentation of peripheral retinal abnormalities, facilitating more precise detection of retinal breaks, lattice degeneration, and vitreoretinal traction. These advancements have influenced clinical decisions, ranging from conservative monitoring to laser therapy or surgical intervention. Furthermore, OCT has provided valuable insights into the pathophysiology of these retinal disorders; however, several challenges persist, including the absence of standardized imaging protocols and variability in the interpretation of morphological findings. While peripheral OCT imaging enhances diagnostic accuracy and clinical management, broader adoption requires standardization of acquisition techniques and diagnostic criteria. We explore the role of WF and UWF OCT in visualizing peripheral retinal degenerations, describing their hallmark features on OCT, evaluating their diagnostic value, clinical impact, and current limitations. Future research should focus on refining imaging protocols, developing automated diagnostic tools, and evaluating the prognostic significance of peripheral OCT findings to improve patient outcomes.