Lattice degeneration of the retina is a condition characterized by thinning and atrophy of the peripheral retina, forming a lattice-like pattern. The retina is the light-sensitive tissue at the back of the eye responsible for transmitting visual signals to the brain. Lattice degeneration typically occurs in the outer edges of the retina and is often bilateral (affecting both eyes).
In lattice degeneration, the affected areas of the retina become more susceptible to tears or holes, which can potentially lead to retinal detachment. Retinal detachment is a serious condition where the retina pulls away from its normal position, causing vision impairment and requiring prompt medical attention.
The exact cause of lattice degeneration is not well understood, but it is believed to have a genetic component, as it can run in families. It is often discovered incidentally during a routine eye examination.
As for the prevalence of lattice degeneration, it is estimated to occur in about 6-10% of the general population. However, the majority of people with lattice degeneration do not experience retinal problems.
Lattice degeneration itself is a risk factor for retinal detachment, but not everyone with lattice degeneration will experience a detached retina. Although 30 percent of retinal detachments are associated with lattice degeneration, the risk of retinal detachment in individuals with lattice degeneration is estimated to be only 1-2%.
Lattice degeneration creates weakened areas in the peripheral retina, and if a tear or hole occurs in these regions, it can lead to a retinal detachment. The vitreous gel inside the eye may pass through the tear and lift the retina from its normal position.
It’s important to note that not all lattice degeneration cases progress to retinal detachment, and many people with lattice degeneration never develop any serious complications. Regular eye examinations by an ophthalmologist are essential for monitoring the condition and identifying any signs of retinal tears or detachment early on.
Factors that may increase the risk of retinal detachment in individuals with lattice degeneration include:
- High Myopia (Nearsightedness): People with high myopia are generally at a higher risk for both lattice degeneration and retinal detachment.
- Previous Retinal Tears or Detachment: If an individual has a history of retinal tears or detachment in one eye, they may be at an increased risk of developing similar issues in the other eye.
- Age: The risk of retinal detachment tends to increase with age.
- Trauma: Injury to the eye can increase the risk of retinal detachment.
While lattice degeneration is a risk factor, not everyone with lattice degeneration will experience retinal detachment. Early detection and prompt treatment of retinal tears can significantly reduce the risk of progression to retinal detachment. Anyone with new onset symptomatic floaters and flashes should seek urgent attention to rule out retinal tear and retinal detachment.
About 25 percent of lattice degeneration lesions contain atrophic retinal holes as seen in the accompanying image. These are not tractional retinal holes and therefore the risk of these holes causing a retinal detachment is low. The lifetime risk of someone with lattice degeneration developing a retinal detachment is about 1-2 percent. In someone with lattice degeneration and atrophic holes, the lifetime risk of retinal detachment is less than two percent.
The patient whose image is shown here has lattice degeneration with a fresh retinal tear.
In that situation, the tear and the adjacent lattice degeneration is lasered. The images show fresh laser then the spots change as they mature first at 2 weeks then at 3 months.
Lattice degeneration is very common. The risk of someone with asymptomatic lattice degeneration developing a retinal detachment is low: about one or two percent. Therefore, laser surgery for asymptomatic lattice degeneration is rarely done. In the past, when retinal detachment surgery was less successful and the risk of lattice degeneration causing a retinal detachment was less well understood, laser therapy of lattice degeneration was commonly performed. At this time, laser for lattice degeneration is sometimes recommended. First, at the time of retinal detachment repair, as in the accompanying image, all areas of lattice degeneration are treated with laser. Second, in a patient who has had a retinal detachment in one eye, the risk of retinal detachment in the fellow eye is fairly high: about 10 percent. For this reason, some retina specialist recommend laser treatment for lattice degeneration lesions in the fellow eye of a patient who has had a retinal detachment.