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Lattice Degeneration

  • Author: David Sarraf, MD; Chief Editor: Hampton Roy, Sr, MD  more...
 
Updated: Sep 25, 2014
 

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 uncommonly complicated by retinal detachment.[3]

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Pathophysiology

The pathogenesis of lattice degeneration is not well understood, although several theories have been proposed.[4] Regional developmental absence of the internal limiting membrane versus abnormal vitreoretinal traction dynamics appears to be the most cogent argument proposed.

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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.

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Contributor Information and Disclosures
Author

David Sarraf, MD Associate Clinical Professor of Ophthalmology, Retinal Disorders and Ophthalmic Genetics Division, Jules Stein Eye Institute, UCLA Geffen School of Medicine, Greater Los Angeles Veterans Affairs Healthcare System

David Sarraf, MD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Coauthor(s)

Stanley M Saulny, MD Consulting Staff, Department of Ophthalmology, Ophthalmology Associates of the Valley

Stanley M Saulny, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Writers Association, American Society of Cataract and Refractive Surgery

Disclosure: Nothing to disclose.

Alex Yuan, MD, PhD EyeSTAR Resident and Postdoctoral Fellow, Department of Ophthalmology, Jules Stein Eye Institute at University of California, Los Angeles

Alex Yuan, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Specialty Editor Board

Simon K Law, MD, PharmD Clinical Professor of Health Sciences, Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, American Glaucoma Society

Disclosure: Nothing to disclose.

Steve Charles, MD Director of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine

Steve Charles, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Macula Society, Retina Society, Club Jules Gonin

Disclosure: Received royalty and consulting fees for: Alcon Laboratories.

Chief Editor

Hampton Roy, Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

V Al Pakalnis, MD, PhD Professor of Ophthalmology, University of South Carolina School of Medicine; Chief of Ophthalmology, Dorn Veterans Affairs Medical Center

V Al Pakalnis, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, South Carolina Medical Association

Disclosure: Nothing to disclose.

Acknowledgements

This review was partly supported by a Research to Prevent Blindness Grant #OP 31 for David Sarraf, MD.

References
  1. Straatsma BR, Zeegen PD, Foos RY, et al. Lattice degeneration of the retina. XXX Edward Jackson Memorial Lecture. Am J Ophthalmol. 1974 May. 77(5):619-49. [Medline].

  2. Byer NE. Lattice degeneration of the retina. Surv Ophthalmol. 1979 Jan-Feb. 23(4):213-48. [Medline].

  3. Lewis H. Peripheral retinal degenerations and the risk of retinal detachment. Am J Ophthalmol. 2003 Jul. 136(1):155-60. [Medline].

  4. Meguro A, Ideta H, Ota M, Ito N, Ideta R, Yonemoto J, et al. Common variants in the COL4A4 gene confer susceptibility to lattice degeneration of the retina. PLoS One. 2012. 7(6):e39300. [Medline]. [Full Text].

  5. Edwards AO, Robertson JE Jr. Hereditary vitreoretinal degenerations. Ryan SJ, ed. Retina. 3rd ed. St. Louis: Mosby; 2001. 482-98.

  6. Byer NE. Long-term natural history of lattice degeneration of the retina. Ophthalmology. 1989 Sep. 96(9):1396-401; discussion 1401-2. [Medline].

  7. Foos RY, Simons KB. Vitreous in lattice degeneration of retina. Ophthalmology. 1984 May. 91(5):452-7. [Medline].

  8. Gonzales CR, Gupta A, Schwartz SD, Kreiger AE. The fellow eye of patients with rhegmatogenous retinal detachment. Ophthalmology. Mar 2004. 111:518-521. [Medline].

  9. Gonzales CR, Gupta A, Schwartz SD, Kreiger AE. The fellow eye of patients with phakic rhegmatogenous retinal detachment from atrophic holes of lattice degeneration without posterior vitreous detachment. Br J Ophthalmol. 2004 Nov. 88(11):1400-2. [Medline].

  10. Folk JC, Arrindell EL, Klugman MR. The fellow eye of patients with phakic lattice retinal detachment. Ophthalmology. 1989 Jan. 96(1):72-9. [Medline].

  11. Ung T, Comer MB, Ang AJ, Sheard R, Lee C, Poulson AV, et al. Clinical features and surgical management of retinal detachment secondary to round retinal holes. Eye. Jun 2005. 19:665-669. [Medline].

  12. Avitabile T, Bonfiglio V, Reibaldi M, et al. Prophylactic treatment of the fellow eye of patients with retinal detachment: a retrospective study. Graefes Arch Clin Exp Ophthalmol. 2004 Mar. 242(3):191-6. [Medline].

  13. Wilkinson CP. Evidence-based analysis of prophylactic treatment of asymptomatic retinal breaks and lattice degeneration. Ophthalmology. 2000 Jan. 107(1):12-5; discussion 15-8. [Medline].

  14. Wilkinson C. Interventions for asymptomatic retinal breaks and lattice degeneration for preventing retinal detachment. Cochrane Database Syst Rev. 2005. CD003170. [Medline].

  15. Mastropasqua L, Carpineto P, Ciancaglini M, Falconio G, Gallenga PE. Treatment of retinal tears and lattice degenerations in fellow eyes in high risk patients suffering retinal detachment: a prospective study. Br J Ophthalmol. Sep 1999. 83:1046-1049. [Medline].

  16. Orlin A, Hewing NJ, Nissen M, Lee S, Kiss S, D'Amico DJ, et al. Pars plana vitrectomy compared with pars plana vitrectomy combined with scleral buckle in the primary management of noncomplex rhegmatogenous retinal detachment. Retina. 2014 Jun. 34(6):1069-75. [Medline].

  17. Wilkinson CP. Interventions for asymptomatic retinal breaks and lattice degeneration for preventing retinal detachment. Cochrane Database Syst Rev. 2014 Sep 5. 9:CD003170. [Medline].

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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.
Another example of wicker lines seen within a lattice lesion. Prophylactic retinopexy has been performed around this lesion.
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.
A large horseshoe tear at the opposite edge of the lattice lesion pictured above. Laser retinopexy surrounds the tear and lattice lesion.
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.
An example of a heavily pigmented lattice lesion.
An acute rhegmatogenous retinal detachment that may be associated with lattice degeneration. (Lattice lesion not seen in this image.)
Another example of a peripheral lattice lesion with a snail-track appearance.
Lattice lesion containing small atrophic holes.
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.
 
 
 
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