Approach Considerations
A dilated eye examination with careful examination of the peripheral retina may be performed.
Laboratory Studies
No appropriate laboratory studies exist for lattice degeneration.
Imaging Studies
Optos camera fundus photography may be useful for annual follow-up and documentation of the condition.
Procedures
Examination by direct and indirect ophthalmoscopy
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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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.
