Criss-Crossing!
𝘓𝘢𝘵𝘵𝘪𝘤𝘦 𝘋𝘦𝘨𝘦𝘯𝘦𝘳𝘢𝘵𝘪𝘰𝘯
● Peripheral retinal degeneration with spindle-shaped areas of retinal thinning, most common degeneration to cause retinal detachment
● 8-10% incidence
● Present in 20-30% of Rhegmatogenous RD
● Symmetrical and bilateral, most common superiorly
𝐀𝐩𝐩𝐞𝐚𝐫𝐚𝐧𝐜𝐞:
● Elongated lesions with long axis parallel to the ora serrata, located in the peripheral retina, usually hyperpigmented and mottled looking
● Sclerosed white vessels display criss-crossing pattern - the appearance responsible for the term ‘lattice’
● Abnormal pigmentation - most common finding - increases with age
● Tiny white or yellow flecks between retinal surface and vitreous cortex
𝐇𝐢𝐬𝐭𝐨𝐥𝐨𝐠𝐲:
● Discontinuity of internal limiting membrane
● Overlying area of liquified vitreous
● Condensation and exaggerated adherence of vitreous gel at margin of lesion
● Atrophy of inner retina
𝐈𝐧𝐝𝐢𝐜𝐚𝐭𝐢𝐨𝐧𝐬 𝐟𝐨𝐫 𝐭𝐫𝐞𝐚𝐭𝐦𝐞𝐧𝐭:
Lattice without retinal breaks - no treatment
Lattice with atrophic holes - no treatment
Lattice + holes + subclinical RD - barrage laser
Lattice + traction tear - treat if fellow eye has RD/ family history of RD/ aphakia
Asymptomatic traction tear- no treatment
Acute symptomatic tear- treat in phakics and aphakics
Image from Rajan Eye Care Hospital
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