Lattice Degeneration Workup

  • Author: David Sarraf, MD; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Feb 23, 2010
 

Laboratory Studies

  • No appropriate lab studies exist for lattice degeneration.
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Imaging Studies

  • No appropriate imaging studies exist for lattice degeneration.
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Procedures

  • Examination by direct and indirect ophthalmoscopy
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Histologic Findings

Histologic studies of autopsy cases demonstrate that lattice lesions are characterized by 3 invariable features: thinning or atrophy of the inner retinal layers, vitreous liquefaction overlying the area of thinned retina, and vitreous condensation and exaggerated vitreoretinal attachments at the borders of the lesions.

The blood vessels within the lesions are usually patent, but they often show fibrous thickening of their walls, which correlates to the white lattice lines seen clinically. Melanin-laden macrophages may explain the pigmentation seen clinically. Glial proliferations may represent overlying preretinal opacities.

Electron microscopic studies have demonstrated retinal thinning, loss of retinal neurons, internal limiting lamina absence, fibrosis of blood vessels, and accumulation of pigment and/or glial elements.

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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 and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Coauthor(s)

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 and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

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, and American Society of Cataract and Refractive Surgery

Disclosure: Nothing to disclose.

Specialty Editor Board

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, and South Carolina Medical Association

Disclosure: Nothing to disclose.

Simon K Law, MD, PharmD  Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles

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

Disclosure: Nothing to disclose.

Steve Charles, MD  Director of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine; Adjunct Professor of Ophthalmology, Columbia College of Physicians & Surgeons; Clinical Professor Ophthalmology, Chinese University of Hong Kong

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

Disclosure: Alcon Laboratories Consulting fee Consulting; OptiMedica Ownership interest Consulting

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

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, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

References

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

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

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

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

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

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

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

  8. 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. Nov 2004;88(11):1400-2. [Medline].

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

  10. 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].

  11. 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. Mar 2004;242(3):191-6. [Medline].

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

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

  14. 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].

 
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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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