Demarcation Laser Photocoagulation for Subclinical Retinal Detachment: Can Progression to Retinal Detachment Be Prevented?

OBJECTIVES: To describe results of demarcation laser photocoagulation in preventing progression of subclinical retinal detachment (SCRD). MATERIALS AND METHODS: Twenty-one eyes of 20 patients with SCRD were included. All patients underwent a complete ophthalmological examination, spectral-domain optical coherence tomography, and color fundus photography. Ages at initial diagnosis ranged between 18 and 75 years (mean: 57.3±16.2 years). Patients followed for at least 6 months were included in the study. Periodic retinal examinations were performed over follow-up periods of 6-55 months using Goldmann three-mirror contact lens and sometimes semilunar mirror lens with scleral indentation. RESULTS: Twelve patients (60%) were female, eight (40%) were male. The mean follow-up period was 24.3±15.2 months (6-55 months). Three (14.3%) eyes were pseudophakic. One patient was affected bilaterally, with both eyes each containing two separate areas of involvement. The SCRD was in the upper quadrant of 18 eyes (85.7%) and the lower quadrant in 3 eyes (14.3%), and was located in the temporal region 10 eyes (47.6%), the nasal quadrant in 4 eyes (19.1%), and in the upper quadrant (temporal-nasal) in 7 eyes (33.3%). Six eyes (28.6%) were found to have myopia greater than -3.0 diopters. Progression to clinical retinal detachment was observed in 4/21 SCRD eyes (19%). All eyes showing progression to clinical retinal detachment had >-3.0 diopter myopia and multiple retinal tears located in the upper quadrant. CONCLUSION: Demarcation laser photocoagulation should be kept in mind as a first-line treatment for eyes with SCRD. Laser photocoagulation is vital in preventing progression to rhegmatogenous retinal detachment in most patients. After this treatment, these patients should be followed closely.