Practice Essentials
Lattice degeneration elevates the risk of retinal detachment but does not require treatment if it is asymptomatic.
Background
Lattice degeneration is a common, atrophic disease of the peripheral retina characterized by oval or linear patches of retinal thinning. [1, 2] The prevalence peaks by the second decade and is believed to be minimally progressive but may be complicated by retinal breaks and retinal detachment. [3]
Pathophysiology
The pathogenesis of lattice degeneration is not well understood, although several theories have been proposed. [4] Regional maldevelopment or absence of the internal limiting membrane versus abnormal vitreoretinal traction dynamics appear to be the most cogent arguments proposed.
Epidemiology
Frequency
United States
Lattice degeneration affects approximately 10% of the population and is bilateral in 30-50% of patients who are affected. A variable familial risk may be present on the basis of various autosomal dominant pedigrees. [5] An increased prevalence exists in myopic eyes, and its prevalence may be associated with increasing axial length, reaching 15% in the longest eyes.
International
No information is available regarding the international occurrence of lattice degeneration.
Mortality/Morbidity
See discussion of retinal detachment in History and Physical.
Race
No reported racial differences exist in lattice degeneration.
Sex
No reported sex differences exist in lattice degeneration.
Age
See History regarding early onset and progression with age.
Prognosis
The prognosis of lattice degeneration is generally good.
Patient Education
Educate the patient on signs of retinal detachment.
Encourage annual follow-up for dilated eye examinations.
Patients with lattice degeneration need to be made aware of their condition and should be warned about the increased lifetime risk of retinal tears or detachment. They should be advised to see an eye doctor immediately if they develop symptoms of retinal tears or detachments, including new floaters, flashes of light, decreasing vision, or a "curtain" in their vision.
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Example of a lattice lesion containing white crisscrossing wicker lines, which are seen in about 10% of lattice lesions. This lesion is complicated by an extensive retinal tear at the cuff of the lesion.
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Another example of wicker lines seen within a lattice lesion. Prophylactic retinopexy has been performed around this lesion.
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An example of a flap tear at the edge of a lattice lesion and three adjacent holes. This area of lattice degeneration has been barricaded by laser retinopexy.
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A large horseshoe tear at the opposite edge of the lattice lesion pictured above. Laser retinopexy surrounds the tear and lattice lesion.
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A peripheral lattice lesion demonstrating the typical snail-track appearance, with overlying vitreal opacities, which may represent glial proliferations or regions of increased vitreoretinal condensation.
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An example of a heavily pigmented lattice lesion.
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An acute rhegmatogenous retinal detachment that may be associated with lattice degeneration. (Lattice lesion not seen in this image.)
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Another example of a peripheral lattice lesion with a snail-track appearance.
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Lattice lesion containing small atrophic holes.
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Radial perivascular chorioretinal degeneration with retinal tear at the margin. These lesions run along vessels and may be found in Wagner's and Stickler's disease.
