Lattice Degeneration - Causes, Signs, Risks, Complications and Management

Introduction

The retina is made of multiple thin layers of nerve tissue located at the back of the eye and plays an essential role in vision. Partially, only a small fraction of the retina is used for central vision, and the periphery is used for extreme side vision. Lattice degeneration is a condition where the retina thins out with time. Retinal degeneration can also lead to tears and breakage of the tissue, which leads to retinal detachment. Retinal detachment is commonly seen with vitreous detachment too. This condition usually affects both eyes and also affects almost 10 percent of the population. Additionally, the condition is usually asymptomatic, but sometimes the severity of the condition can lead to photopsia or flashing of light in the periphery of the vision in both eyes.

What Are the Causes of Lattice Degeneration?

The cause of lattice degeneration is unknown, but the following are the etiological factors associated with this condition:

• Myopia: Myopia is the name used for the condition where people have difficulty seeing far away things but can see close objects.

• Stickler Syndrome: It is a genetic condition that can cause many health-related complications, such as hearing loss, vision impairment, or joint pain. This condition is also known as arthro-ophthalmopathy.

• Ehlers-Danlos Syndrome: It is a genetic condition where a person’s skin, blood vessels, and joints are affected. Due to this disorder, the patient has complications such as fragile skin, dislocation of joints, or poor muscle tone. This disorder can lead to retinal detachment too.

• Marfan Syndrome: It is a life-threatening condition of connective tissue where there are some health-related complications associated with the eyes, heart, bones, and blood vessels. There are many complications associated with this disorder, such as nearsightedness, lens dislocation, retinal detachment, astigmatism (the refractive error of the eye, where a person cannot see an object that is near or at distanced), glaucoma (it is a group of eye conditions caused by optic nerve damage), or cataract in children.

What Are the Signs and Symptoms of Lattice Degeneration?

The following are the signs and symptoms associated with lattice degeneration:

• Blurred vision.

• Altered vision.

• Grayish black spots or stringy webs in the field of vision.

• Flashing lights in the vision.

• Curtain-type structure or shadow in the vision.

• Problems with peripheral vision.

How to Diagnose Lattice Degeneration?

There are the following diagnostic methods used for lattice degeneration:

• Eye Examination: A normal eye checkup is used to check for any symptoms related to the condition. During this examination, all the functions, along with the visuality of the eyes, are checked.

• Slit Lamp Examination: This diagnostic method is also known as biomicroscopy. During this test, the ophthalmologist checks for any eye-related complications. There is no requirement for pre-examination preparation, and the doctor can do this in his office. However, two types of drops are given to the patient before this examination; one for washing off tears and the other for dilation of pupils. Patients are asked to place their chin and head in front of the instrument. A slit lamp is nothing but a high-intensity light that doctors use along with a microscope to examine different parts of the eyes. The complications such as detached retina, macular degeneration, cataract, or injury can be diagnosed with this.

• Fundus Examination: Fundoscopic examination is a routine diagnostic test that ophthalmologists make to check the eye.

• Ancillary Imaging: This supplementary examination is used to check for lattice degeneration.

• Wide-Field Imaging: It is an advanced diagnostic method used for getting two dimensional or three dimensional imaging of the retinal tissue beyond 50 degrees of a field area. It is beneficial for patients with smaller pupil sizes and provides a time-efficient and accurate image of the retina.

What Are the Risks Factors Associated With Lattice Degeneration?

The following are the risk factors associated with Lattice Degeneration:

• Genetics: Although the causes behind lattice degeneration are unknown, there are some documented cases suggesting a relation between genetics and occurrence. In some cases, family history has increased the chances of developing this condition.

• Myopia: Nearsightedness is another risk factor that increases the chances of having this condition.

• Poor Circulation: Due to insufficient blood supply or lack of nutrients in the blood supply, lattice degeneration is aggravated. The posterior ciliary artery is responsible for supplying nutrients to the retinal equator to the front of the eye. Due to obstruction in this artery, the watershed zone is created with micro capillaries.

• Macular Holes: It is a rare condition caused by many factors, such as age and contraction of the vitreous gel.

What Are the Complications Associated With Lattice Degeneration?

The following are the complications associated with lattice degeneration:

• Clogging of blood vessels.

• Lesion formation on the retina.

• Retinal atrophy.

• Liquefaction of vitreous gel due to the retinal lesion.

• Contraction of vitreous.

• Retinal detachment.

• Tearing of retina.

• Retinal thinning.

• Neural atrophy.

• Accumulation of glial material.

• Pigmentary changes.

• Vascular fibrosis.

How to Manage Lattice Degeneration?

There is no treatment required for lattice degeneration. However, the symptoms or complications associated with it should be managed to stop further damage to the eyes. There are the following management options available for lattice degeneration:

• Cryotherapy: Cryotherapy is a preventive therapy used to manage retinal complications and the weakening of the retinal periphery. Depending on the condition, the doctor may or may not recommend the treatment.

• Laser Treatment: This treatment option is only required for a severe case of retinal detachment or an aggressive family history of lattice degeneration.

Depending on the type of lesion, this is a list of recommendations for the treatment of peripheral retinal lesions:

Conclusion

Lattice degeneration has unknown causes, but there are some conditions or circumstances aggravating this condition. Patients with this condition are not usually seen with any type of signs and symptoms. If the condition progresses and the patient’s vision is compromised, they should see the ophthalmologist immediately with prompt treatment. For instance, a severe case can be further treated by cryotherapy or laser treatment.