This patient presented with a macula-on rhegmatogenous retinal detachment (RRD). Optos color RG imaging shows the causative retinal tear with a bridging vessel. The RRD was successfully repaired with vitrectomy.
Learning Points:
The overall risk of an acute PVD causing a retinal break or detachment is about 5% (Seider et al, Ophthalmology 2022;129:67-72), and this risk is increased in the presence of vitreous pigment or blood. The reason for this is that, as in our patient, the retina often tears along a blood vessel. An occult retinal break is often the cause of an unexplained vitreous hemorrhage, which is why early vitrectomy is often recommended for these eyes, even when a break cannot be found on office examination (Flores-Sanchez et al, Eye 2023;37:3191-3196).
The bridging vessels in retinal breaks can also cause recurrent vitreous hemorrhage, a condition known as the avulsed retinal vessel syndrome (Robertson et al, Arch Ophthalmology 1971;85:669-672). The traction can spontaneously release, or vitrectomy may be required for sputtering hemorrhages or non-clearing blood.
