What is lattice degeneration and how common is it?
Lattice degeneration, also called “lattice” for short, is a common form of degenerative change seen the peripheral retina that is found in 6-8% of the general population. Approximately 50% of patients with lattice degeneration in one eye will have lattice degeneration in their other eye. Forty percent will have atrophic holes in the retina within these lesions.
Why should anyone care about lattice degeneration?
Even though retinal detachment is very rare (1 in 10,000), lattice degeneration is a risk factor for retinal detachment and approximately 30% of spontaneous retinal detachments that occur in eyes without previous surgery are associated with lattice degeneration. Most of these eyes will have a horseshoe shaped retinal tear as the cause of the retinal detachment. Rarely, atrophic holes within lattice can lead to RD. Lattice is more likely to be associated with retinal detachment in near sighted eyes and eyes that have had previous surgery. Commonly, the presence of lattice degeneration runs in families. No one knows for sure whether lattice increases the risk for retinal detachment following laser vision correction treatment for near sighted eyes.
What does lattice look like on examination?
The clinical appearance is that of circumferentially oriented cigar-shaped areas of retinal whitening and/or pigmentation seen in the anterior retina. The retina within lattice is exceptionally thin and the vitreous jelly is abnormally adherent to the edges of the lesions. This thinning of the retina and the abnormal vitreous attachment predisposes these areas to tear when the vitreous gel pulls on the retina.
Does lattice degeneration require treatment?
If there are horseshoe-shaped retinal tears associated with lattice degeneration, they are treated thermally with either laser or cryotherapy. Lattice with and without atrophic holes is often not treated, unless the lattice is associated with early sub-retinal fluid, or is found in the other eye in a patient who has suffered a previous retinal detachment. Sometimes, lattice is treated pre-operatively for other types of eye surgery.