Subclinical retinal detachment resulting from asymptomatic retinal breaks: prognosis for progression and regression.
OBJECTIVE
To give a more accurate epidemiologic description of subclinical retinal detachments and to learn their prognosis.


METHODS
Prospective, natural history cohort study.


METHODS
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.


METHODS
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.
Byer
N E
NE
Department of Ophthalmology, University of California School of Medicine, Los Angeles, California, USA.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012075:Remission, Spontaneous; D012163:Retinal Detachment / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D012167:Retinal Perforations / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors