Lattice degeneration
Encyclopedia
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 8% of the general population and occurs in about 40% of eyes with retinal detachment. 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
.
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 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.
, 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.
It is not known if research is being carried out to find a cure for lattice degeneration.
Human eye
The human eye is an organ which reacts to light for several purposes. As a conscious sense organ, the eye allows vision. Rod and cone cells in the retina allow conscious light perception and vision including color differentiation and the perception of depth...
where peripheral
Peripheral
A peripheral is a device attached to a host computer, but not part of it, and is more or less dependent on the host. It expands the host's capabilities, but does not form part of the core computer architecture....
retina
Retina
The vertebrate retina is a light-sensitive tissue lining the inner surface of the eye. The optics of the eye create an image of the visual world on the retina, which serves much the same function as the film in a camera. Light striking the retina initiates a cascade of chemical and electrical...
becomes atrophic in a lattice pattern and may develop tears / breaks / holes, which may further progress to retinal detachment
Retinal detachment
Retinal detachment is a disorder of the eye in which the retina peels away from its underlying layer of support tissue. Initial detachment may be localized, but without rapid treatment the entire retina may detach, leading to vision loss and blindness. It is a medical emergency.The retina is a...
. 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
Ischemia
In medicine, ischemia is a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue. It may also be spelled ischaemia or ischæmia...
and fibrosis
Fibrosis
Fibrosis is the formation of excess fibrous connective tissue in an organ or tissue in a reparative or reactive process. This is as opposed to formation of fibrous tissue as a normal constituent of an organ or tissue...
.
It is present in about 8% of the general population and occurs in about 40% of eyes with retinal detachment. Similar lesions are seen in patients with Marfan syndrome
Marfan syndrome
Marfan syndrome is a genetic disorder of the connective tissue. People with Marfan's tend to be unusually tall, with long limbs and long, thin fingers....
, Stickler syndrome
Stickler syndrome
Stickler syndrome is a group of genetic disorders affecting connective tissue, specifically collagen. It was first studied and characterized by Gunnar B. Stickler in 1965. Stickler syndrome is a subtype of collagenopathy, types II and XI...
and Ehlers-Danlos syndrome
Ehlers-Danlos syndrome
Ehlers–Danlos syndrome is a group of inherited connective tissue disorders, caused by a defect in the synthesis of collagen . The collagen in connective tissue helps tissues to resist deformation...
, all of which are associated with an increased risk of retinal detachment
Retinal detachment
Retinal detachment is a disorder of the eye in which the retina peels away from its underlying layer of support tissue. Initial detachment may be localized, but without rapid treatment the entire retina may detach, leading to vision loss and blindness. It is a medical emergency.The retina is a...
.
Signs
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.
Treatment
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.
Prognosis
No complications are encountered in most patients with lattice degeneration, however in young myopesMyopia
Myopia , "shortsightedness" ) is a refractive defect of the eye in which collimated light produces image focus in front of the retina under conditions of accommodation. In simpler terms, myopia is a condition of the eye where the light that comes in does not directly focus on the retina but in...
, 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.
It is not known if research is being carried out to find a cure for lattice degeneration.