This 51YO male presented with a completely asymptomatic superior rhegmatogenous retinal detachment. There was a history of blunt trauma 1 year earlier.
We discussed the various surgical options, and he decided to proceed with laser demarcation due to the lack of symptoms and remote history of the causative injury. The immediate post-laser Optos image shows the barrier laser treatment.
We were unable to reach the ora with the slit lamp delivery system, so the anterior edges were subsequently treated with cryotherapy.
Learning Points:
When demarcating these detachments, it is critical that the retinopexy completely surrounds the subretinal fluid and that treatment extends to the ora; otherwise, the detachment can spread through the untreated retina.
Patients need to be followed postoperatively, as detachment can occasionally progress despite prior retinopexy.
See Vrabec and Baumal, Ophthalmology 2000;107:1063-1067 for an excellent review regarding demarcation laser photocoagulation for selected macula-sparing retinal detachments.
