Abstract
Purpose :
Demarcation laser photocoagulation is commonly used to prevent the progression of retinal detachments (RDs) however its use to specifically treat symptomatic large retinal breaks (over 8 disc diameters (DD)) associated with significant subretinal fluid has not been as well reported. We performed a retrospective, observational clinical study to evaluate the efficacy of demarcation laser photocoagulation in preventing the progression to RD of large retinal breaks with significant subretinal fluid.
Methods :
Demographics, past medical and ocular history, best corrected visual acuity at presentation and follow-up, retinal break characteristics, laser photocoagulation characteristics, and clinical course information were collected for 9 patients who presented with large retinal tears with significant subretinal fluid between May 2016 and September 2018 and were subsequently treated with demarcation laser photocoagulation. Standard descriptive statistics were used to characterize patient data.
Results :
The mean age was 53.7 (range 31-65) years and the mean length of follow-up was 7.4 (SD=6.3) months. Average best-corrected visual acuity was 20/101 (SD=116.8) at presentation and 20/93 (SD=128.2) at most recent follow-up. Average break size was 16.2 DDs (SD=6.2). 2 of 9 patients treated eventually progressed to RD requiring pars plana vitrectomy. Common features seen in these two patients included temporal location (one IT, one ST) of the break, presence of other retinal breaks, eventual macula involvement, and presence of posterior vitreous detachment. None of these measures were statistically significantly different between the group that progressed to RD and the group that did not. Both patients who progressed to RD did so within 30 days of laser application.
Conclusions :
Seven of 9 patients (78%) treated with demarcation laser photocoagulation for large retinal breaks with significant subretinal fluid did not require additional surgical treatment for progression to RD. These findings suggest that laser photocoagulation with close follow-up may be a reasonable non-surgical option for patients with large retinal breaks associated with significant subretinal fluid.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.