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Lattice Degeneration of the Retina
Lattice Degeneration of Retina Leading to Retinal Detachment

Presentation

Prevalence It is present in about 8 percent of the general population and occurs in about 40 percent of eyes with retinal detachment. Symptoms The patient is nearly always asymptomatic, except for possible complaints of flashing lights. [retinahawaii.com]

Lattice degeneration was present in at least one eye of 12 patients (20%). Seven patients had bilateral lesions. [ncbi.nlm.nih.gov]

Variable features of lattice lesions include abnormal pigmentation (present in 82 percent), yellow-white surface flecks (present in 80 percent) and branching white lines, which represent occluded or sheathed vessels (present in 17 percent). [reviewofophthalmology.com]

Lattice degeneration is present in 11% of fellow eyes in patients with rhegmatogenous retinal detachments. [8, 9, 10] Rhegmatogenous retinal detachment is shown in the image below. [emedicine.medscape.com]

Workup

Other Pathologies

  • Gliosis

    […] cause subsequent retinal detachment Fundoscopy: circumferential area of involvement with small criss-crossing white lattice lines (thickened hyalinized blood vessels) Microscopic (histologic) description Atrophic and thinned retina with superficial gliosis [pathologyoutlines.com]

Treatment

In one case laser treatment was not able to cause a firm chorioretinal adhesion and RD progressed to the macula despite the treatment. In this highly myopic patient a complete PVD was present at the time of laser treatment. [bjo.bmj.com]

Treatment should be considered if the detachments are documented to increase in size.4,5 Generally, however, atrophic round holes within lattice lesions and minimal subretinal fluid do not require treatment. [ejournalofophthalmology.com]

The risk of retinal detachment in lattice degeneration with atrophic holes was estimated to be about 1 in 90 patients, and prophylactic treatment for this common anomaly is not readily recommended. [ncbi.nlm.nih.gov]

Methods of prophylactic treatment Subclinical retinal detachment (>1-disc diameter of subretinal fluid but Laser photocoagulation is the primary method of prophylactic treatment. [emedicine.medscape.com]

April 2011 Volume 52, Issue 14 Free ARVO Annual Meeting Abstract | April 2011 Treatment Of Lattice Degeneration In Vitrectomy For Rhegmatogenous Retinal Detachment Author Affiliations & Notes Young-Joon Jo Ophthalmology, Chungnam National University, [iovs.arvojournals.org]

Prognosis

Subclinical RD was seen in 10 (6.7%) of 150 eyes with atrophic holes, involving 9 (7.5%) of 120 patients, and had a much less serious prognosis than clinical detachment. [ncbi.nlm.nih.gov]

Prognosis The prognosis of lattice degeneration is generally good. Patient Education Educate the patient on signs of retinal detachment. Encourage annual follow-up for dilated eye examinations. [emedicine.medscape.com]

Prognosis The prognosis for lattice degeneration in itself is good. The vast majority of patients will have lesions that are completely stable or slowly progressive. [eyewiki.aao.org]

[…] to reduce risks of retinal detachment in symptomatic lattice degeneration. [ citation needed ] There are documented cases wherein retina detached from areas which were otherwise healthy despite being treated previously with laser. [ citation needed ] Prognosis [en.wikipedia.org]

Prognosis No complications are encountered in most patients with lattice degeneration, although in young myopes, retinal detachment can occur. [ipfs.io]

Etiology

The etiology of this degeneration is still uncertain, but it is likely that both genetic and environmental factors play important roles in its development. [ncbi.nlm.nih.gov]

P athophysiology The etiology of lattice is questionable. It appears to be due to dropout of peripheral retinal capillaries with resulting ischemia, which induces thinning of all retinal layers. [eyecaretrust.org.uk]

Lattice Degeneration Etiology Lattice degeneration is a common clinical entity which has many morphologies. [eyewiki.aao.org]

Epidemiology

The epidemiology of lattice degeneration is summarized, as are the possible precursors to retinal detachment. A clinical characterization of the natural history of lattice degeneration is offered, and interventions for complications are described. [ncbi.nlm.nih.gov]

Epidemiology Frequency United States Lattice degeneration affects approximately 10% of the population and is bilateral in 30-50% of patients who are affected. [emedicine.medscape.com]

Pathophysiology

This discussion outlines the pathophysiology of lattice retinal degeneration and the relationship of pathophysiology to clinical presentation. [ncbi.nlm.nih.gov]

[…] 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] Pathophysiology [emedicine.medscape.com]

[…] loss of neurons, accumulation of glial material, pigment changes, and changes to the inner limiting lamina. [2] It has also been shown that there is a lack of basement membrane over the surface of lattice lesions and replacement with astrocytes. [3] Pathophysiology [eyewiki.aao.org]

Although the etiology of familial retinal detachment associated with lattice degeneration is thought to be polygenic and/or multifactorial [8], the pathophysiological mechanism and underlying genetic factors remain unknown. [journals.plos.org]

Prevention

Preventive treatment of lattice degeneration has not been shown to prevent retinal detachment, but lattice degeneration should be monitored. [bouldereyesurgeons.com]

[…] and Early detection There are no effective methods of preventing the vitreous changes that lead to RRD. [ejournalofophthalmology.com]

Lasers or cryoretinopexy are sometimes used prophylactically to help prevent retinal detachments. [retinahawaii.com]

He may remember a visit or brochure from a treatment plan, and his training will kick in, and you’ll hear about there being some treatment to help prevent retinal detachment. [endmyopia.org]

In certain cases, laser treatment is performed to prevent retinal tears and detachment in asymptomatic high-risk individuals. Stephen Ong Tone [retinacanada.com]

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