17.1 Features
Lattice degeneration is a peripheral retinal condition in which there is retinal thinning, possible hyalinization of retinal vessels creating a “lattice” appearance, and increased vitreoretinal adhesion. Patients with lattice degeneration are at an increased risk for retinal tears and rhegmatogenous retinal detachment. Lattice degeneration can be associated with two types of retinal breaks: round atrophic holes (full-thickness breaks with no associated free operculum and no posterior vitreous detachment, PVD) and those associated with tractional tears (usually located at the border of lattice lesions).
17.1.1 Common Symptoms
Asymptomatic but associated with conditions such as PVD, retinal tears, detachments, or vitreoretinal traction, which may cause floaters or photopsias.
17.1.2 Exam Findings
Morphology can be quite varied. The shape of the lattice degeneration can be round, oval, or linear and it tends to be located near the equator of the retina or between the equator and the vitreous base. It tends to be oriented parallel to the ora serrata (in a circumferentially oriented pattern). Lattice degeneration derives its name from the whitish lines which represent hyalinized retinal vessels, though this is not always present. Other features include superficial whitish yellow flecks, patches of varying degrees of pigmentation, and small atrophic round holes.
17.2 Key Diagnostic Tests and Findings
17.2.1 Optical Coherence Tomography
Optical coherence tomography (OCT) is not typically performed or necessary for diagnosis. However, OCT may identify focal areas of traction, retinal thinning, and disruption of retinal tissue in areas of retinal breaks. This may be visualized with widefield/peripheral OCT or intraoperative OCT (▶ Fig. 17.1).
Fig. 17.1 (a) Intraoperative optical coherence tomography (OCT) of lattice degeneration. Intraoperative photograph with OCT cross-hairs over area of lattice degeneration (asterisk). (b) Horizontal OCT (green arrow in [a]) demonstrates flat retina in area adjacent to lattice degeneration. (c) Vertical OCT (pink arrow in [a]) through the lattice degeneration demonstrates significant vitreoretinal traction (white arrow) and subretinal fluid with associated cystic changes.
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