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What Is Lattice Retinal Degeneration?

Lattice retinal degeneration is a peripheral retinal condition characterized by elongated, lattice like patches of retinal thinning, white lines, and overlying vitreous changes. These areas often have sclerosed vessels, pigment clumps, and round holes. Lattice is common in myopic eyes and tends to occur in the superior or superotemporal periphery. While many people remain asymptomatic, lattice regions have a higher risk of developing retinal tears and rhegmatogenous retinal detachment. Regular monitoring helps detect complications early.

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What Is Lattice Retinal Degeneration?

Lattice retinal degeneration is a peripheral retinal condition characterized by elongated, lattice like patches of retinal thinning, white lines, and overlying vitreous changes. These areas often have sclerosed vessels, pigment clumps, and round holes. Lattice is common in myopic eyes and tends to occur in the superior or superotemporal periphery. While many people remain asymptomatic, lattice regions have a higher risk of developing retinal tears and rhegmatogenous retinal detachment. Regular monitoring helps detect complications early.

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Causes and Pathology of Lattice Degeneration

The exact cause is not fully defined, but lattice degeneration reflects localized retinal thinning, vessel closure, and vitreoretinal adhesion. Genetic predisposition and axial myopia increase risk. Within lattice areas, the inner retina is atrophic and the overlying vitreous is condensed, leading to firm attachments at lesion borders. Traction at these edges can create round atrophic holes or horseshoe tears. These defects provide pathways for liquefied vitreous to enter the subretinal space and start a detachment.

Symptoms and Clinical Features

Most individuals with lattice degeneration have no symptoms and learn about it during a routine dilated exam. When tears or detachments develop, patients may notice flashes of light, new floaters, or a curtain like shadow in the peripheral field. On fundus examination, lattice lesions appear as cigar shaped or oval patches with crisscrossing white lines, pigment changes, and sometimes round holes. Surrounding vitreous often looks liquefied with strong adhesions at lesion edges. Lesions are frequently bilateral and symmetric in myopic eyes.

How Is Lattice Retinal Degeneration Diagnosed?

Diagnosis is made through careful dilated peripheral retinal examination with indirect ophthalmoscopy and scleral depression. The eye doctor inspects for characteristic lattice lesions, associated holes, and any signs of subretinal fluid. Wide field imaging can document the distribution and size of lesions. In eyes with symptoms, optical coherence tomography and B scan ultrasonography help detect early detachments. Family history and degree of myopia are considered in assessing overall risk.

How Is Lattice Retinal Degeneration Managed?

Most lattice degeneration is observed without prophylactic treatment, especially when no symptoms or high risk features are present. Patients receive education about warning signs of retinal tear or detachment and the need for urgent evaluation if these arise. Prophylactic laser photocoagulation is sometimes used for symptomatic lesions, those with tractional horseshoe tears, or when a fellow eye has had a detachment. Regular follow up visits track changes, particularly in highly myopic or young patients.

FAQs About Lattice Retinal Degeneration

Does lattice degeneration mean I will get a retinal detachment?

Most people with lattice never develop a detachment, but the risk is higher than in eyes without lattice. Awareness of symptoms and regular exams help protect vision.

Should all lattice lesions be treated with laser?

Not necessarily. Laser is usually reserved for lesions with tears, traction, or other high risk features. Routine lattice without symptoms is often just monitored.

Is lattice degeneration hereditary?

There is a genetic component, especially in families with myopia and retinal detachment history, but inheritance patterns are not always clear. Family members with symptoms should have eye exams.

Can I play sports if I have lattice degeneration?

Many people continue normal activities, though some doctors advise avoiding high impact sports that risk head trauma. Discuss specific activities with your eye care professional based on your overall risk.