From the Guidelines
Lattice degeneration is primarily caused by a combination of genetic factors, myopia, and abnormal vitreoretinal adhesions, which lead to thinning and weakening of the peripheral retina. This condition affects approximately 6-10% of the general population and has a strong hereditary component, often running in families 1. The exact genetic mechanisms remain unclear, but the condition involves abnormal vitreous attachments to the retina and structural changes in retinal tissue.
Key Factors Contributing to Lattice Degeneration
- Genetic factors: Lattice degeneration has a strong hereditary component, often running in families 1.
- Myopia (nearsightedness): Substantially increases the risk, with higher degrees of myopia associated with greater prevalence of lattice degeneration 1.
- Abnormal vitreoretinal adhesions: Where the vitreous gel pulls on the retina, creating mechanical stress that weakens the retinal structure over time 1.
- Vascular changes in the peripheral retina: Including reduced blood flow to affected areas, may also contribute to the development of lattice degeneration by causing localized ischemia and tissue atrophy 1.
- Age: Lattice degeneration typically develops during adolescence and early adulthood 1.
High-Risk Groups
- Individuals with myopia, particularly those with higher degrees of myopia, are at increased risk of developing lattice degeneration and subsequent retinal detachment 1.
- Patients with a history of nontraumatic detachment in one eye have a 10% increased risk of developing retinal detachment in the fellow eye 1.
- Individuals with certain systemic conditions, such as Stickler syndrome, may also be at increased risk of developing lattice degeneration and retinal detachment 1.
From the Research
Causes of Lattice Degeneration
- Lattice degeneration is considered the most significant peripheral retinal disorder potentially predisposing to retinal breaks and retinal detachment 2.
- The condition affects the vitreous and inner retinal layers with secondary changes as deep as the retinal pigment epithelium and perhaps the choriocapillaris 2.
- Variations in clinical appearance are common, and lattice lesions favor the vertical meridians between the equator and the ora serrata 2.
- Lattice degeneration begins early in life and has been reported in sequential generations of the same family, suggesting a possible genetic component 2, 3.
- The association between the vitreous and retina in lattice lesions may be responsible for the majority of lattice-induced retinal detachments 2.
- A study found that common variants in the COL4A4 gene confer susceptibility to lattice degeneration of the retina, indicating a genetic predisposition 4.
- Another study suggested that lattice degeneration may be related to open angle glaucoma, particularly in patients with myopia 5.
- The tumultuous event of posterior vitreous separation in the presence of abnormally strong vitreoretinal adherence is the trigger for a retinal tear that, in turn, may lead to retinal detachment 2, 6.
Genetic Factors
- First-degree relatives of proband patients with lattice degeneration of the retina revealed a significantly higher prevalence of the disease than the prevalence in the general population 3.
- The inheritance pattern did not fit well to a monogenic mode of inheritance, and it was hypothesized that a polygenic or multifactorial mode of inheritance is the most likely for lattice degeneration of the retina 3.
- A genome-wide association study identified one microsatellite locus, D2S0276i, in the collagen type IV alpha 4 (COL4A4) gene on chromosome 2q36.3, which was associated with lattice degeneration of the retina 4.