This 65YO male presented with light perception in his left eye secondary to a very chronic total rhegmatogenous retinal detachment (RRD).
Optos color imaging captured the detachment, which was fairly stiff due to diffuse proliferative vitreoretinopathy (PVR). Two posterior retinal breaks are seen.
The retina was successfully reattached with vitrectomy, inferior retinectomy, and silicone oil.
Learning Points:
PVR, which consists of cellular membranes growing on either retinal surface, develops in about 5-10% of retinal detachments. The membranes contract, foreshorten the retina, and likely proliferate as an aberrant wound-healing response. There are no proven pharmacologic therapies to prevent or treat PVR.
These complex detachments can be managed with vitrectomy with membrane peeling, retinectomy, scleral buckling, and silicone oil. However, PVR remains the main cause for ultimate retinal reattachment surgical failure.
See Garweg et al Surv Ophthalmol 2013;48:321-329 for a good review of PVR pathophysiology.
