Proliferative Vitreoretinopathy

Fixed posterior folds are characteristics of advanced PVR. 

  • 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