This 74YO female was referred on 5/31/22 for an asymptomatic rhegmatogenous retinal detachment (RRD) in her right eye.
Optos color RG imaging shows a chronic appearing superotemporal macula-on RRD with a single retinal break. A faint demarcation line is noted along the detachment’s posterior edge. The detachment was subsequently demarcated with thermal laser photocoagulation posteriorly and cryotherapy to its anterior edges.
We have been examining her twice yearly since. When last examined on 10/8/25, the detachment remained well-demarcated and without spread, with scarring from laser and cryotherapy. Optos Silverstone RGB swept-source OCT shows a broad area of outer retinal atrophy within the area of retinopexy.
Learning Points:
Demarcation, rather than reattachment, of the retina is a valid option for select cases of RRD. 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.
