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  • Nonsurgical management of RRD may be reasonable for asymptomatic patients

    Retina/Vitreous

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    Review of: Asymptomatic rhegmatogenous retinal detachments: Outcomes in patients without initial surgical intervention

    Sengillo J, Smiddy W, Lin B, et al. Ophthalmology Retina, September 2022


    As an initial strategy, observation of patients with RRD who are asymptomatic may outweigh risks of surgery, when there appears to be a low risk of progression. 

    Study design

    This is a retrospective case series, looking at the long-term outcomes of patients diagnosed with asymptomatic rhegmatogenous retinal detachments at the Bascom Palmer Eye Institute between 2011 and 2021. The study included 18 patients (20 eyes) and the mean follow up was 5 years.

    Outcomes

    The majority of asymptomatic RDs occurred in the inferotemporal quadrant (85%). The final BCVA was 20/40 or better in 95% of the eyes that were followed during this time period. Twenty-five percent of the patients were treated with prophylactic laser demarcation. During follow-up, 10% of patients exhibited progression of their asymptomatic RD and required surgical intervention.

    Limitations

    The major limitation of this study is its retrospective nature. Additionally, this was a small study, with only 20 eyes fitting the inclusion criteria within the 10-year timeframe of the chart review.

    Clinical significance

    Although rarely done, close observation of asymptomatic retinal detachment may be considered in a select groups of patients. The majority of these patients will have an inferotemporal retinal detachment. Ultra-wide field imaging may be helpful in following these patients.