Lattice Degeneration
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Lattice degeneration elevates the risk of retinal detachment but does not require treatment if it is asymptomatic.
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]
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.
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.
See discussion of retinal detachment in History and Physical.
No reported racial differences exist in lattice degeneration.
No reported sex differences exist in lattice degeneration.
See History regarding early onset and progression with age.
The prognosis of lattice degeneration is generally good.
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.
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].
Byer NE. Lattice degeneration of the retina. Surv Ophthalmol. 1979 Jan-Feb. 23(4):213-48. [Medline].
Lewis H. Peripheral retinal degenerations and the risk of retinal detachment. Am J Ophthalmol. 2003 Jul. 136(1):155-60. [Medline].
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].
Edwards AO, Robertson JE Jr. Hereditary vitreoretinal degenerations. Ryan SJ, ed. Retina. 3rd ed. St. Louis: Mosby; 2001. 482-98.
Byer NE. Long-term natural history of lattice degeneration of the retina. Ophthalmology. 1989 Sep. 96(9):1396-401; discussion 1401-2. [Medline].
Foos RY, Simons KB. Vitreous in lattice degeneration of retina. Ophthalmology. 1984 May. 91(5):452-7. [Medline].
Gonzales CR, Gupta A, Schwartz SD, Kreiger AE. The fellow eye of patients with rhegmatogenous retinal detachment. Ophthalmology. Mar 2004. 111:518-521. [Medline].
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].
Folk JC, Arrindell EL, Klugman MR. The fellow eye of patients with phakic lattice retinal detachment. Ophthalmology. 1989 Jan. 96(1):72-9. [Medline].
Ho TC, Ho A. Long-term natural course of lattice degeneration of the retina in high myopic eyes – A ten-year long term study. Investigative Ophthalmology & Visual Science. 2015. 56 (7):
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].
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].
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].
Wilkinson C. Interventions for asymptomatic retinal breaks and lattice degeneration for preventing retinal detachment. Cochrane Database Syst Rev. 2005. CD003170. [Medline].
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].
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].
Wilkinson CP. Interventions for asymptomatic retinal breaks and lattice degeneration for preventing retinal detachment. Cochrane Database Syst Rev. 2014 Sep 5. 9:CD003170. [Medline].
Hemang K Pandya, MD Fellow in Vitreoretinal Disease and Surgery, Dean McGee Eye Institute, University of Oklahoma College of Medicine
Hemang K Pandya, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Association for Research in Vision and Ophthalmology, Michigan State Medical Society, Michigan Society of Eye Physicians & Surgeons
Disclosure: Nothing to disclose.
Ilya (Eli) M Sluch, MD Fellow in Cornea, Bascom Palmer Eye Institute
Ilya (Eli) M Sluch, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, American Medical Association, American Society of Cataract and Refractive Surgery
Disclosure: Nothing to disclose.
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 Founder and CEO of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine
Disclosure: Received royalty and consulting fees for: Alcon Laboratories.
Andrew A Dahl, MD, FACS Assistant Professor of Surgery (Ophthalmology), New York College of Medicine (NYCOM); Director of Residency Ophthalmology Training, The Institute for Family Health and Mid-Hudson Family Practice Residency Program; Staff Ophthalmologist, Telluride Medical Center
Andrew A Dahl, MD, FACS is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, American Intraocular Lens Society, American Medical Association, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Medical Society of the State of New York, New York State Ophthalmological Society, Outpatient Ophthalmic Surgery Society
Disclosure: Nothing to disclose.
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.
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.
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.
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.
This review was partly supported by a Research to Prevent Blindness Grant #OP 31 for David Sarraf, MD.
Lattice Degeneration
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