Cryotherapy proven to reduce retinal detachment risk in Stickler syndrome

This large retrospective study found that prophylactic cryotherapy is safe and markedly reduces the risk of retinal detachment in patients with type 1 Stickler syndrome.

The authors compared 293 patients with Stickler syndrome receiving prophylaxis with up to 36.1 years of follow-up with 194 Stickler syndrome patients not receiving treatment (controls). Time to retinal detachment was compared between patients who received bilateral prophylaxis and untreated controls, with and without individual patient matching. Patients receiving unilateral prophylaxis (after fellow eye retinal detachment) were similarly compared with an appropriate control subgroup.

The bilateral control group had a 7.4-fold increased risk of retinal detachment compared to the bilateral prophylaxis group, and the matched bilateral control group had a 5.0-fold increased risk compared to the matched bilateral prophylaxis group.

The unilateral control group had a 10.3-fold increased risk of retinal detachment compared to the unilateral prophylaxis group, and the matched unilateral control group had an 8.4-fold increased risk compared to the matched unilateral prophylaxis group. There were no significant long-term side effects of cryotherapy.

They note that the observed treatment effect of the current retrospective study is so large that it is highly unlikely to be completely due to biases and confounding factors. In fact, the study was designed to weight against the benefit of treatment to ensure the true treatment effect was underestimated.