N E Byer1. 1. Department of Ophthalmology, University of California School of Medicine, Los Angeles, California, USA.
Abstract
PURPOSE: To give a more accurate epidemiologic description of subclinical retinal detachments and to learn their prognosis. DESIGN: Prospective, natural history cohort study. PARTICIPANTS: Seventeen patients, with 19 eyes involved with 22 separate areas of subclinical retinal detachment (SCRD). Ages at initial diagnosis ranged between 14 and 67 years. METHODS: Periodic retinal examinations over follow-up periods of between 8 months and >33 years, using indirect ophthalmoscopy and scleral indentation, and sometimes slit-lamp vitreous examinations with Goldmann lens. MAIN OUTCOME MEASURES: Documentation with written descriptions and drawings of lesions and estimation of size and dimensions. RESULTS: The rate of progression to clinical retinal detachment (CRD), which involved 11% of eyes (2 of 18), was found to be exactly equal to the likelihood of spontaneous regression and disappearance, also found in 11% (2 of 18), without any treatment. The calculated incidence rate of progression to CRD was 0.008 (<1% per year). Also, myopic females were found to have a 4.7-times greater risk of subclinical retinal detachment developing than were males, P = 0.036. All of these findings are reported for the first time in the ophthalmic literature. CONCLUSIONS: Compared with symptomatic clinical retinal detachment, SCRD is much less threatening to the vision and the health of the eye. Therefore, SCRD does not require or justify routine treatment but should be reexamined at regular annual intervals or more frequently if changes are observed. If it definitely progresses to CRD, surgical treatment is justified.
PURPOSE: To give a more accurate epidemiologic description of subclinical retinal detachments and to learn their prognosis. DESIGN: Prospective, natural history cohort study. PARTICIPANTS: Seventeen patients, with 19 eyes involved with 22 separate areas of subclinical retinal detachment (SCRD). Ages at initial diagnosis ranged between 14 and 67 years. METHODS: Periodic retinal examinations over follow-up periods of between 8 months and >33 years, using indirect ophthalmoscopy and scleral indentation, and sometimes slit-lamp vitreous examinations with Goldmann lens. MAIN OUTCOME MEASURES: Documentation with written descriptions and drawings of lesions and estimation of size and dimensions. RESULTS: The rate of progression to clinical retinal detachment (CRD), which involved 11% of eyes (2 of 18), was found to be exactly equal to the likelihood of spontaneous regression and disappearance, also found in 11% (2 of 18), without any treatment. The calculated incidence rate of progression to CRD was 0.008 (<1% per year). Also, myopic females were found to have a 4.7-times greater risk of subclinical retinal detachment developing than were males, P = 0.036. All of these findings are reported for the first time in the ophthalmic literature. CONCLUSIONS: Compared with symptomatic clinical retinal detachment, SCRD is much less threatening to the vision and the health of the eye. Therefore, SCRD does not require or justify routine treatment but should be reexamined at regular annual intervals or more frequently if changes are observed. If it definitely progresses to CRD, surgical treatment is justified.