26.1

Lattice Degeneration

Introduction:

Lattice degeneration is a common finding in the peripheral retina. It is characterized by localized retinal thinning with overlying premature vitreous syneresis and traction. This commonly results in atrophic holes, but retinal tears and subsequent retinal detachment are much more uncommon. This condition is estimated to occur in about 8% of the general population, and is more common in moderately myopic individuals. Approximately 40% of eyes with retinal detachments have lattice degeneration.

Clinical Findings:

The vast majority of affected patients are asymptomatic with lattice being noted as an incidental finding on a dilated retinal examination. Some patients may complain of photopsias and floaters. Typical lattice consists of sharply demarcated spindle-shaped areas of retinal thinning usually located in the retinal periphery between the equator of the retina and the posterior border of the vitreous base (Fig. 26.1.1). Lattice degeneration occurs more frequently temporally and superiorly in the retina. The retina may be thinned and atrophic. Atrophic holes are the most commonly seen type of retinal break, which typically remain stable, and are rarely associated with retinal detachments. Occasionally, vitreous traction over lattice can cause formation of horseshoe retinal tears which may result in retinal detachment.

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