Proliferative Vitreoretinopathy

• Most common cause of failure in retinal reattachment surgery
• Characterized by the formation of cellular membrane on both surfaces of the retina and in the vitreous
• Predisposed by retinal break
• Contraction of the cellular membranes lead to tractional and rhegmatogenous retinal detachments

Clinical Features

• Symptoms: loss of vision especially with extensive PVR involving the macula
• Signs:
  • Retinal break
  • Diffuse vitreous haze, pigment clumps or clusters on the retina
  • Wrinkling of inner retina, retinal stiffness associated with decreased mobility of the vitreous
  • Full thickness, fixed folds which may be located posterior or anterior to the equator.
  • The severity is expressed by the number of clock hours involved in the proliferations
  • Condensed vitreous strands

Management

• Scleral buckling to close the retinal breaks in mild PVR
• Surgical relief of traction
• Retinopexy for stabilization of reattached retinal breaks