This 71YO male presented with one year of poor vision in his left eye following vitrectomy with silicone oil elsewhere for a rhegmatogenous retinal detachment. Vision was light perception.
Pseudocolor SLO imaging shows a complex pattern of interlacing subretinal fibrosis bands. OCT scanning shows areas of disorganized retinal thinning, thickened disorganized retina nasally, and retinal detachment more temporally. Observation was recommended given the poor visual prognosis.
Learning Points:
Proliferative vitreoretinopathy (PVR), which consists of cellular membranes growing on either retinal surface, develops in about 5-10% of RRD. The membranes contract, foreshorten the retina, and likely represent an aberrant wound-healing response. There are no proven pharmacologic therapies to prevent or treat PVR. These complex detachments can be managed with vitrectomy and 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.
