Retro-mode scanning laser ophthalmoscopy in diagnosis of peripheral retinal lesions

Background: Retro-mode scanning laser ophthalmoscopy (RM-SLO) allows clear visualization of neurosensory defects and detachment in the central retina. So, from a clinical perspective, the potential of RM-SLO to visualize peripheral subclinical retinal detachments and retinal breaks looks attractive. However, this application of RM-SLO has not been previously studied or reported. Aim: to study the diagnostic potential of retro-mode scanning laser ophthalmoscopy (RM-SLO) for evaluation of peripheral retinal lesions. Methods: Based on indirect ophthalmoscopy, 26 asymptomatic individuals with lattice retinal degeneration, retinal break, or retinal detachments were included (52 eyes, 15 males and 11 females, 34.8±11.8 years) in the peripheral retinal lesions group and 25 individuals (50 eyes, 10 males and 15 females, 42.8±14.5 years) were included in the group without peripheral retinal lesions. All participants were examined with RM-SLO for the presence of peripheral retinal lesions in a masked fashion. Detection rate for retinal breaks and detachments were compared between indirect ophthalmoscopy and RM-SLO. Results: Compared to indirect ophthalmoscopy, RM-SLO categorizes 20.7% (p = 0.031) more eyes as having local asymptomatic retinal detachment or at least one retinal break. Cumulatively, RM-SLO demonstrates 55.0% (p = 0.001) more local asymptomatic retinal detachments and 29.0% (p = 0.004) more asymptomatic retinal breaks. Conclusions: RM-SLO showed high potential in diagnosing peripheral retinal lesions and may be a useful additional diagnostic option for patients who demonstrate peripheral retinal lesions with indirect ophthalmoscopy.