Laser Prophylaxis in Patients With Stickler Syndrome
By Megan Mulholland
Selected by Andrew P. Schachat, MD
Journal Highlights
Ophthalmology Retina, April 2022
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Stickler syndrome is a collagenopathy that causes pediatric retinal tears and detachments. Some evidence suggests that prophylactic treatment can reduce retinal detachments (RDs) in patients, but study findings are inconsistent. Moreover, after reattachment, only 33% to 64% of patients experience improvement in visual acuity (VA). Khanna et al. set out to evaluate the impact of laser prophylaxis on RD and VA. They found that extended vitreous base laser (EVBL) appeared to reduce the rate of subsequent RD and was associated with better VA.
For this retrospective study, the researchers evaluated 115 patients (230 eyes) who were treated with EVBL (n = 129 eyes), nonprotocol laser (NPL; n = nine eyes), or no laser (n = 92 eyes). Patients’ median age at time of treatment was 9.5 years (range, 6-13). For those who developed an RD after treatment, the median age at time of RD occurrence was 11 years (range, 7-18).
RDs occurred in four (3%) of the EVBL eyes, in all nine NPL eyes (100%), and in 65 (70.6%) of the eyes that did not undergo laser treatment. With regard to visual outcomes, patients who underwent EVBL had better final VA and lower rates of low vision than did those who had NPL or no laser. Overall, EVBL eyes averaged 8 lines better vision—and only one eye treated with EVBL had low vision, versus 33% of the eyes that received NPL or no laser.
The authors noted that their study has several limitations, including the lack of a confirmed genetic mutation for the majority of the patients. Nonetheless, given the number of patients in the study, the findings constitute “at least preliminary evidence” that prophylactic treatment with EVBL may prevent RD and is associated with better VA in patients with Stickler syndrome, they said.
The original article can be found here.