Spotlight on Lattice Degeneration Imaging Techniques

Abstract

Lattice degeneration (LD), routinely diagnosed with indirect ophthalmoscopy, is one of the most common and clinically significant peripheral retinal findings. In this review, we have summarized the data on currently available imaging techniques which help to improve diagnosis and our understanding of LD pathogenesis. Ultra-wide field imaging provides reliable color fundus capturing for the primary diagnosis of LD and may also be used as a screening tool. Wide-field imaging can be used for targeted documentation of LD lesions using true colors and with minimal optical distortions. Information on the status of the vitreoretinal interface, including detection of retinal holes, detachments, and vitreous tractions, can be obtained with peripheral structural optical coherence tomography (OCT) or scanning laser ophthalmoscopy in retro-mode. These techniques clarify the associated risks of rhegmatogenous retinal detachment. Fundus autofluorescence can provide details on atrophic changes. However, the risk of retinal detachment by means of this technique requires further investigation. OCT angiography may be successfully performed for some lesions. Taken together, OCT and OCT angiography demonstrate thinning of the choroid, alteration of local choroidal microcirculation, and, in severe lesions, involvement of the sclera. OCT angiography confirms loss of retinal microcirculation within LD lesion, which was previously shown with fluorescein angiography. In conclusion, despite relatively simple primary diagnosis, imaging of LD lesions remains challenging due to their peripheral localization. However, several new strategies, including ultra-wide field imaging, peripheral OCT, and scanning laser ophthalmoscopy, make LD imaging possible on a routine basis, improving diagnosis and understanding of LD pathogenesis.

Involvement of Sclera in Lattice Retinal Degeneration: An Optical Coherence Tomography Study

“…Assessment of the risk of retinal detachment associated with lattice lesions is a subject of clinical interest, where OCT represents a relatively novel informative tool [ 4 , 8 , 14 , 15 ]. Based on the findings of this study, we propose scleral indentation as an anti-risk characteristic of lattice lesions.…”

“…Two technologies, infrared scanning laser ophthalmoscopy and optical coherence tomography, suggest involvement of the sclera, at least in some lattice lesions. Particularly, scleral involvement has appeared on cross-sectional optical coherence tomography (OCT) as a scleral indentation in the middle of the lesion [ 8 ]. However, the frequency, detailed characteristics, and clinical meaning of scleral involvement in LD remain unknown.…”