Laser treatment for Stickler syndrome protects against retinal detachment

This retrospective study investigated extended vitreous base laser (EVBL) treatment in patients with Stickler syndrome. Results were assessed through rates of retinal detachment and visual acuity.

Study design

This was a comparative retrospective case series that examined treatment of patients with Stickler syndrome from 2006 to 2020. Included were 230 eyes of 115 patients. The median age at the time of laser prophylaxis treatment was 9.5 years and the median age of patients with RD was 11 years. Of the 230 eyes, 92 did not undergo any laser treatment, 9 received nonprotocol laser (NPL) treatment, and 129 received EVBL treatment.

Outcomes

Three percent of eyes that received EVBL treatment developed a retinal detachment within the study time period (2006-2020), compared to 73% of eyes that received either no laser or NPL. The eyes that underwent EVBL had considerably better vision (8 lines better).

Limitations

As this was a retrospective series, the treatment arms were not randomized and some baseline characteristics did vary. The EVBL group was younger at baseline (9 years vs 13 years old). A larger percentage of patients in the non-EVBL group presented at baseline with retinal detachment. Genetic confirmation of the Stickler syndrome diagnosis was not available for most of the patients.

Clinical significance

This was a large series of a relatively uncommon disease and despite the limitations of the retrospective study design the data strongly favor the use of EVBL in Stickler syndrome. The study confirms our knowledge that Stickler syndrome has a very high risk of retinal detachment, often at young age. The application of EVBL appears to significantly decrease the retinal detachment rate and improve visual outcomes.