Optical coherence tomography features of lattice degeneration

Lattice degeneration (LD) of the retina is a peripheral retinal disorder marked by retinal thinning, vitreoretinal adhesions, and abnormal pigmentation. LD is often asymptomatic but can lead to sight-threatening complications, such as retinal tears and rhegmatogenous retinal detachment. Despite its prevalence, there is limited research on its structural characteristics using advanced imaging. This study aims to characterize the optical coherence tomography (OCT) features of lattice degeneration, which may be useful in guiding future management strategies.

This cross-sectional, prospective study analyzed ultra-widefield (UWF) OCT images from 53 eyes of 39 patients, collected from 2 clinical centers (Doheny-UCLA Eye Centers in Los Angeles and AIIMS-New Delhi) over a 1-year period. Lattice degeneration was confirmed by retina specialists through ophthalmoscopy and verified by pseudocolor UWF imaging (Optos Silverstone), and only cases with peripheral OCT scans obtained through the lattice region were included. Various OCT features were assessed at the location of the lattice lesion, including vitreoretinal adhesion, retinal and choroidal thickness, intraretinal hyperreflective foci (IHRF), retinal cystoid spaces, atrophic holes, retinoschisis, and subretinal fluid. Inter-grader reliability was measured using Cohen's κ coefficient.

All lattice degeneration lesions exhibited retinal thinning, and 96.2% demonstrated vitreoretinal adhesion at the lesion borders. Choroidal abnormalities were observed in 90.5% of cases, with 81.1% showing choroidal thinning and 9.4% exhibiting choroidal thickening. IHRF was identified in 54.7% of lesions, while increased retinal reflectivity was present in 45.3%. Retinal cystoid spaces and atrophic holes were detected in 24.5% and 17% of lesions, respectively. Less common features included subretinal fluid in 11.3% and retinoschisis in 3.8% of cases.

This peripheral OCT study confirms that while retinal thinning and vitreoretinal adhesion are frequent and consistent findings in lattice degeneration lesions, choroidal abnormalities are also nearly always present. The relevance of these findings to the pathophysiology of these lesions and their impact on progression warrants further study.