Proliferative Retinal Detachment Clinical Presentation

  • Author: Steve Charles, MD; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Mar 2, 2012
 

History

History findings include the following:

  • Visual loss in the part of the visual field corresponding to the initial area of retinal detachment (chief complaint)
  • Field loss - Shadows, loss of portions of the visual field
  • Light flashes
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Physical

Retinal examination using binocular indirect ophthalmoscopy reveals the following:

  • Retinal detachment
  • Combination of star folds, fixed folds, subretinal proliferation, and vitreous contraction[16] - In some patients, the vitreous contraction component predominates, whereas in other patients, the periretinal proliferation is more apparent. Subretinal proliferation can be annular (napkin ring), placoid, or dendritic (bands, strands). Hypocellular vitreous contraction can involve circumferential fibers, radial preequatorial fibers, and contracted anterior and posterior vitreous cortex.[2, 3]
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Causes

Retinal breaks directly or indirectly cause most cases of proliferative vitreoretinopathy. Direct causation is a result of the loss of contact inhibition of retinal glial cells and RPE cells. Proliferative vitreoretinopathy may also result from cryopexy, diathermy, and laser retinopexy, especially if excessive.

Gas and silicone may contribute to proliferative vitreoretinopathy by sequestrating RPE, inflammatory, and glial cells; fibronectin; various cytokines; and fibrin at the retinal surface.

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Proceed to Differential Diagnoses
 
 
Contributor Information and Disclosures
Author

Steve Charles, MD  Director of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine; Adjunct Professor of Ophthalmology, Columbia College of Physicians and Surgeons; Clinical Professor Ophthalmology, Chinese University of Hong Kong

Steve Charles, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Club Jules Gonin, Macula Society, and Retina Society

Disclosure: Alcon Laboratories Consulting fee Consulting; OptiMedica Ownership interest Other; Topcon Medical Lasers Consulting fee Consulting

Specialty Editor Board

Russell P Jayne, MD  Consulting Vitreoretinal Surgeon, The Retina Center at Las Vegas

Russell P Jayne, MD is a member of the following medical societies: American Medical Association, American Society of Cataract and Refractive Surgery, and American Society of Retina Specialists

Disclosure: Nothing to disclose.

Simon K Law, MD, PharmD  Associate Professor of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

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