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 a scar tissue formation within the eye.

Symptoms | Causes | Treatment


What are the symptoms


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

What are the causes?

 

When a retinal detachment and the formation of a retinal tear occur, 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. 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?

 

Although PVR is a catastrophic complication of retinal detachment surgery and can cause profound visual loss, it has gone from being unsuccessful to be repairing 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, while an alternative silicone oil is most commonly used to hold the retina in position. The advantage of the gas bubble is that is goes away on its own and the patient does not require another operation.

The advantage of the silicone oil bubble is that the patient does not have to have any head positioning for two to three weeks following surgery like he do with gas and can resume his normal activities in a few days. The disadvantage is that silicone oil requires removal several months after the procedure.

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