Clinical Outcomes of Symptomatic Horseshoe Tears After Laser Retinopexy

Purpose: To determine the clinical course of patients treated for acute symptomatic horseshoe retinal tears (HSTs). Methods: A retrospective chart review was performed of patients presenting between January 2014 and December 2021 with acute onset of floaters and/or flashes who were found to have horseshoe retinal tear HRT(s) without retinal detachment (RD). Patients were included if they had at least 3 months of follow-up. Exclusion criteria were a rhegmatogenous RD (RRD) at initial presentation, asymptomatic HST(s), operculated hole, atrophic hole, retinal dialysis, history of trauma, or previous retinal surgery. Charts were reviewed for subsequent new HST(s), progression to RRD, and development of epiretinal membrane (ERM). Characteristics, including age, sex, eye laterality, phakic status, high myopia, lattice degeneration, and vitreous hemorrhage (VH) at initial presentation, were also noted. The main outcome measures were the percentage and timing of subsequent new HST(s), progression to RRD, and development of ERM. Results: The study included 216 eyes (199 patients). The mean age was 60.4 years. Of the eyes, 27.3% had lattice degeneration and 6.5% high myopia. At presentation, 25.9% of eyes had a VH. Twenty-seven eyes (12.5%) experienced new tear(s); 63.0% occurred between 1 month and 3 months. Progression to RRD occurred in 15 eyes (6.9%); 53.3% occurred within 3 months. On multivariate logistic regression, VH was a significant risk factor (odds ratio, 6.48; P = .002) for progression to new HST(s) or RRD. Conclusions: Eyes treated for acute symptomatic HSTs require ongoing follow-up. Although new retinal tears and progression to RRD tends to occur within 3 months, these events can occur later.