Lattice Degeneration

Lattice Degeneration
SYMPTOMS Typically asymptomatic but may experience flashes and/or floaters
SIGNS Bilateral in 50% of eyes
Round, oval, or linear area of pigmentation and/or white patches that typically run parallel to the ora serrata and are found in the peripheral retina. Other signs include Sclerotic white lines, RPE depigmentation, Glistening yellowish flecks
May be associated with atrophic retinal holes (18% of the time) and retinal tears (25% of the time)
Shafer sign may be seen in the presence of a retinal tear
WORK-UP Full eye exam with dilated retinal exam, Scleral depression, Peripheral 90D, Gonioscopy 3-mirror (using retina mirrors)
TREATMENT Typically, no treatment is needed and retina needs to be monitored with the following: Lattice degeneration without retinal tears, retinal holes, and symptoms / Lattice degeneration without retinal holes and retinal tears but with symptoms of flashes and/or floaters / Lattice degeneration with associated retinal holes without subretinal fluid and without symptoms of flashes and/or floaters
Refer to a retinal specialist ASAP if patient presents with the following: Lattice degeneration with an associated retinal tear / Lattice degeneration with associated retinal holes and subretinal fluid / Lattice degeneration with associated retinal holes without subretinal fluid but with symptoms of flashes and/or floaters
FOLLOW-UP Lattice degeneration without retinal tears, retinal holes, and symptoms: See patient back in 12 months
Lattice degeneration without retinal holes and retinal tears but with symptoms of flashes and/or floaters: See patient back in 4-6 months
Lattice degeneration with associated retinal holes without subretinal fluid and without symptoms of flashes and/or floaters: See patient back in 4-6 months
If patient was seen and treated by a retinal specialist and the retina is stable, the patient should be seen back in 6-12 months
ADDITIONAL LAB | TESTS None
ETIOLOGY Retinal thinning occurs due to loss of peripheral retinal capillaries with subsequent retinal ischemia
DIFFERENTIAL DX Cobblestone degeneration, Peripheral cystoid degeneration, White without pressure, Chorioretinal scar
NOTES Lattice degeneration is found normally in 6-10% of the population (this percentage increases in myopic patients)
Lattice degeneration is typically found in the superior quadrants (most common) and inferior quadrants of the retina
Only 1-3% of eyes with lattice degeneration develop a retinal detachment
Retinal tears associated with lattice degeneration are typically found at the margin or edge of lattice degeneration
Snail track degeneration is a variant of lattice degeneration or an early stage of lattice degeneration (similar size, shape, appearance, and potential complications of lattice degeneration but is white-gray in color with white-yellow flecks and no pigment)
Lattice Degeneration: Retinal photo demonstrating a large retinal tear associated with lattice degeneration https://emedicine.medscape.com/article/1223956-clinical#b4
Posted in Ocular Conditions, Retina-Periphery