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Lattice degeneration is a disease of the eye where peripheral retina becomes atrophic in a lattice pattern and may develop tears / breaks / holes, which may further progress to retinal detachment. It is an important cause of retinal detachment in young myopic individuals. The cause is not known but pathology reveals vascular insufficiency resulting in ischemia and fibrosis.
It is present in about 6-8% of the general population and occurs in approximately 30% of phakic retinal detachments. Similar lesions are seen in patients with Marfan syndrome, Stickler syndrome and Ehlers-Danlos syndrome, all of which are associated with an increased risk of retinal detachment. Risk of developing lattice degeneration in one eye is also increased if lattice degeneration is already present in the other eye.
Typical lattice consists of sharply demarcated spindle-shaped areas of retinal thinning usually located between the equator of the retina and the posterior border of the vitreous base. This is more frequently located in the temporal half of the retina and is seen more superiorly than inferiorly.
Atypical lattice is characterised by radial lesions which appear continuous with the peripheral blood vessels. This type is typically seen in patients with Stickler syndrome.
Barrage laser is at times done prophylactically around a hole or tear associated with lattice degeneration in an eye at risk of developing a retinal detachment.
Barrage laser has not shown to be effective in preventing retinal detachment in patients with asymptomatic lattice degeneration. So prophylactic treatment for asymptomatic lattice degeneration with laser coagulation is useless.
However laser photocoagulation has been shown to reduce risks of retinal detachment in symptomatic lattice degeneration. However there are documented cases where retina detached from areas which were otherwise healthy despite being treated previously with laser.
No complications are encountered in most patients with lattice degeneration, however in young myopes, retinal detachment can occur. There are documented cases with macula-off retinal detachment in patients with asymptomatic lattice degeneration. Partial or complete vision loss almost always occurs in such cases. Unfortunately, such young patients who are otherwise healthy have to spend the rest of their lives with impaired vision. Currently there is no prevention or cure for lattice degeneration.