Pathologies

Proliferative vitreoretinopathy



Proliferative vitreoretinopathy (PVR) is the most common complication of a retinal detachment (RD), and occurs in approximately 8-10% of patients who develop an RD. Proliferative vitreoretinopathy, despite the long name, is simply scar tissue formation within the eye.

What are the symptoms of proliferative vitreoretinopathy?

Loss of vision especially with extensive PVR involving the macula and same symptoms as retinal detachment.

What causes proliferative vitreoretinopathy?

At the time of a retinal detachment and the formation of a retinal tear, RPE cells that are normally under the retina come through the retinal tear and enter the vitreous cavity. Even after the retinal detachment is repaired these cells proliferate on the surface of the retina and sometimes under the retina, in sheets, which contract and pull the retina back off. Proliferative vitreoretinopathy (PVR) is the most common complication of a retinal detachment (RD), and occurs in approximately 8-10% of patients who develop an RD.

What is the treatment for proliferative vitreoretinopathy?

Although PVR is a catastrophic complication of retinal detachment surgery and can cause profound visual loss, it has gone from being unsuccessful to be repaired in the late 1970s to having a very high success rate in repairing PVR detachments today. Vitrectomy is used to remove the scar tissue and re-attach the retina with special fluids and gases.
Perfluoron used to "push" retina back into position while PVR membranes are peeled from retina allowing the retina to be re-attached and vision to be rehabilitated.

The retina is now reattached with Perfluoron holding the retina in position while laser is applied to connect the retina permanently. PFO is then removed and replaced with gas or silicone.

A gas bubble may be placed in the eye to hold the retina in place while it is healing, as an alternative silicone oil is most commonly used to hold the retina in position. The advantage to the gas bubble is that is goes away on its own, and the patient does not require another operation. The advantage to the silicone oil bubble is that the patient does not have to have any head positioning for two to three weeks following surgery like they do with gas and can go back to normal activities in a few days. The disadvantage is that silicone oil requires removal in several months following the procedure.

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