Free Lattice Generation Software

[Jessia Adachi]

isa condition that involves abnormal thinning of the peripheral retina, which is the tissue that lines the back wall of the eye and is critical for maintaining good vision. When lattice degeneration is present, the retina is more vulnerable to developing tears, breaks, or holes that could ultimately lead to a visually debilitating condition called a retinal detachment. For this reason, once diagnosed lattice degeneration should be closely monitored.

Clinically, lattice degeneration is characterized by oval or straight patches of thinned retina, sometimes accompanied by pigment clumps or a crosshatching pattern formed by sclerotic vessels (Figure 1). Lattice may be found in only one eye, but often is present in both. There may be just one lesion or clusters of many. Lattice is often located along the outer border of the retina.

Figure 1. Photograph of the peripheral retina demonstrates an area of lattice degeneration. Note the retinal thinning, which is characterized by a color change. There are also pigment clumps and crosshatching of sclerotic vessels, two features commonly observed in lattice degeneration. Hamid Ahmadieh, MD, Labbafinejad Medical Center. Retina Image Bank 2015; Image 25882. 2018, American Society of Retina Specialists.

Lattice degeneration itself does not cause symptoms, so the only way to diagnose the condition is with a dilated fundus examination by an eye care provider. A dilated fundus examination is done by administering dilating eye drops in your eyes to expand the pupil so that the retina can be carefully evaluated. Dilating drops will cause your vision to be blurry for several hours before returning to normal.

The eye care specialist will then use a headlight and a special lens to perform the exam. Depending on the nature of your findings, the doctor may also examine your retina while exerting a slight amount of pressure around your eye (scleral depression). In general, no imaging tests are necessary to diagnose this disease, although some providers may obtain wide-angle photographs of your retinas to assist in monitoring your condition.

Lattice degeneration occurs in 8% to 10% of the general population and its cause is not fully understood. There does not appear to be a correlation in incidence by gender or race. And while this condition does not follow a definitive inheritance pattern, it frequently clusters within families. It is most commonly found in patients with myopia

(nearsightedness), but lattice-like lesions are also seen in rare diseases such

as Stickler syndrome, Ehlers-Danlos, and Marfan syndrome. There is no

prevention or cure for lattice degeneration.

Lattice degeneration itself does not cause symptoms. However, in rare cases it can lead to a retinal tear or detachment, which are very serious conditions that require

prompt attention from an ophthalmologist or retina specialist.

Symptoms include:

Lattice is thought to be minimally progressive and fortunately, the vast majority of patients with this condition never develop a retinal tear or detachment. Therefore, in general, no treatment is needed for lattice degeneration aside from regular monitoring with dilated fundus examinations.

In rare circumstances, some physicians may perform preventive laser therapy or cryotherapy (a type of freezing treatment) to strengthen the peripheral retina in the areas where it is weak. Your doctor will discuss the risks and benefits of doing so with you if he or she thinks it is worth considering. It is not known if these interventions are effective in preventing retinal complications.

Rarely, lattice degeneration can lead to complications such as a retinal tear or detachment. Symptoms to look out for include blurry vision, a curtain obscuring part of the outer visual field, flashing lights, and new floaters. If any of these occur, you should seek prompt attention from an ophthalmologist or retina specialist.

In those who do develop a retinal tear or detachment, treatment will be performed, typically by a retina specialist. This treatment can range from a laser treatment completed in the office to surgery in the operating room, depending on the severity of the condition.

In summary, lattice degeneration is a relatively common condition that affects the retina, especially in nearsighted people. While its presence increases the risk of a retinal tear or detachment, the vast majority of patients will never experience symptoms or complications from their lattice degeneration.

If you are diagnosed with lattice degeneration, the most important actions you can take to protect the health of your eyes are to visit your eye care provider on a regular basis and know the symptoms of a retinal tear or detachment so you can seek prompt treatment if needed.

Lattice degeneration of the retina occurs when your retina gets thinner over time. About 10% of people experience this condition within their lifetime. It does not directly cause vision issues, but people with this condition are more likely to contend with a retinal tear or detachment.

Most people who have lattice degeneration have no symptoms. The condition is usually discovered during routine eye exams. However, people with lattice degeneration need to be on the lookout for symptoms of a retinal tear, which include:

Most people who have lattice degeneration have it in both of their eyes. While it is rare to develop a retinal detachment even if you have lattice degeneration, between 20 and 30 percent of people who have the most common type of retinal detachment also have experienced lattice degeneration.

Experts are not sure exactly what causes lattice degeneration. However, they do know there are certain people who are more at risk of developing the condition. It is not always inherited, but it does run in some families.

People who are nearsighted are the most likely to develop lattice generation. Being nearsighted means you have difficulty seeing far away but can see more clearly up close. Another name for nearsightedness is myopia.

If you have lattice degeneration, you should simply get regular eye exams with a dilated fundus examination. During this type of test, your eye doctor will put special eye drops in your eyes to dilate your pupils. This opens them up more to let your doctor see the fundus of your eye. The fundus includes a lot of the important working parts, including the retina.

If your doctor thinks you are at greater risk of a retinal tear or detachment, they may offer to perform a procedure to strengthen the retina. Such procedures include laser therapy or cryotherapy. However, these procedures have not been proven to work to prevent retinal tears or detachments.

Pneumatic retinopexy. During this procedure, your doctor will use medicine to numb your eye while you are awake. They will then remove a small amount of eye fluid. They will put a small air bubble in the eye to put the retina into its proper place, then use a laser to repair holes in your retina.

Scleral buckle surgery. You will undergo general anesthesia and be asleep during this procedure. Your doctor will place a band around the sclera of your eye, which is the white part. This squeezes your eye slightly, pushing on the sides to encourage your retina to reattach. Your doctor might also use a laser or cryotherapy to fix holes in the retina. The band stays on your eye after surgery.

Vitrectomy. Vitrectomy is a similar procedure to retinopexy. However, it is often used to treat more severe retinal detachments and tears and is done in a hospital operating room rather than a doctor's office. Many people receive full anesthesia for this procedure; however, some receive just a local anesthetic. During the surgery, your doctor will use a laser to repair your retina, inject an air bubble to keep your retina in place, and may also replace some of the eye fluid with a synthetic fluid like silicone oil.

In general, the prognosis for lattice degeneration is positive. Most people who get lattice degeneration do not develop complications and don't require any treatment. Experts believe the condition progresses, but slowly.

The prognosis is also good in the rare case that you do get a retinal detachment. 90% of retinal detachments can be fixed with surgery, and most require just one operation. As long as you seek medical care, there is a high likelihood that your vision will recover.

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Lattice degeneration is a common peripheral retinal degeneration that is characterized by localized retinal thinning, overlying vitreous liquefaction, and marginal vitreoretinal adhesion. The condition is associated with atrophic retinal holes, retinal tears, and retinal detachments. Lattice degeneration is a common condition that can be found in 6-8% of the general population[1] though past histologic studies on autopsy suggest a prevalence as high as 10.7% [2]

The etiology of lattice degeneration is unknown, though theories include developmental anomalies of the internal limiting membrane, embryologic vascular anastomosis, localized retinal ischemia, or the contention that it is a primary vitreopathy leading to the formation of abnormal vitreous traction.[2][7]

Atrophic round holes occur within the substance of the lattice lesion and likely represent the end-stage of retinal thinning and subsequent dissolution of tissue. [2] These holes rarely progress to a clinical retinal detachment though may develop a small cuff of subretinal fluid stemming from the overlying liquefied vitreous. As this cuff typically remains stable over time, it is believed that the overlying liquid vitreous does not communicate with the greater vitreous body.[2] Overall, a small percentage of retinal detachments are caused by lattice degeneration with atrophic holes (2.8% from one study).[10] And conversely, the risk of a retinal detachment developing in a patient with lattice degeneration associated with atrophic hole has been estimated to be less than 0.3%.[2] Interestingly, these retinal detachments occur more frequently in young, myopic patients, an observation possibly explained by the progressive strengthening of the bond between the retina and retinal pigment epithelium at the border of the hole with time.[2]

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