Asymptomatic Rhegmatogenous Retinal Detachments: Outcomes in Patients without Initial Surgical Intervention.

ABSTRACT

OBJECTIVE: To report long-term outcomes of patients with asymptomatic retinal detachments (RDs) who did not undergo initial surgical intervention. DESIGN: Retrospective case series. METHODS: A retrospective chart review of patients diagnosed with asymptomatic RD. Patients with symptoms of photopsias or a visual field defect at presentation were excluded. PARTICIPANTS: Eighteen patients seen and evaluated at the Bascom Palmer Eye Institute between 2011 and 2021. MAIN OUTCOME MEASURES: Best-corrected visual acuity (BCVA), presence or absence of progression of RD, and whether surgical intervention occurred during follow-up. RESULTS: The study group included 18 patients (20 eyes). The mean follow-up duration was 5.1 years (range, 0-30 years). Risk factors included myopia (95%), lattice retinal degeneration (60%), and pseudophakia (5%). Most asymptomatic RDs were located in the inferotemporal quadrant (80%), followed by the superotemporal (15%) and inferonasal (5%). No RDs were confined to the superonasal quadrant. The majority (80%) extended posterior to the equator and were ≤ 3 clock hours in size (65%). Five (25%) patients were previously treated with prophylactic laser demarcation. Final BCVA was 20/40 or better in 19 (95%) eyes and between 20/40 and 20/200 in 1 (5%) eye. During the follow-up, 2 (10%) patients exhibited progression of their asymptomatic RD and underwent surgical intervention. Retinal pathology in fellow eyes was previously diagnosed or identified during follow-up in 14 (78%) of 18 patients, of which 2 (11%) patients had bilateral asymptomatic RDs. CONCLUSIONS: Nonsurgical management with observation may be reasonable as an initial management strategy for asymptomatic patients with RDs in select cases. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.