Vitreoschisis‐induced vitreous cortex remnants: missing link in proliferative vitreoretinopathy

Overdam, Koen A van

doi:10.1111/aos.14216

Cited by 28 publications

(49 citation statements)

References 7 publications

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“…Given that TA is not routinely used for vitreous removal, we believe that the presence of VCR is often missed and, therefore, underestimated. 6 , 7 , 8 , We found that VCR can be much more widespread across the retina and is a far more common finding than previously thought. Also, in all patients who developed a redetachment due to PVR, VCR were present over the mid-peripheral and peripheral retina and not (entirely) removed during the first surgery, in highly myopic as well as in emmetropic eyes.…”

Section: Introductionmentioning

confidence: 47%

“…Therefore, we proposed that VCR are a causal link in the development of PVR membranes, where VCR can act as a scaffold for fibrocellular proliferation, while hyalocytes present in VCR may play a role in developing an inflammatory response and membrane formation. 6 This case report aims to demonstrate the relationship between the presence of VCR over the retinal surface and the formation of PVR by histopathology.…”

Section: Introductionmentioning

confidence: 99%

“…However, we proposed anomalous posterior vitreous detachment (PVD) with vitreoschisis as a common etiology. 6 During spontaneous or surgical PVD, the inner lamellae of the posterior vitreous cortex may separate from the retina while the outermost lamellae remain attached to the retinal surface as vitreoschisis-induced vitreous cortex remnants (VCR). The presence of these VCR on the posterior pole has already been associated with idiopathic macular pathology.…”

Section: Introductionmentioning

confidence: 99%

“…Also, in all patients who developed a redetachment due to PVR, VCR were present over the mid-peripheral and peripheral retina and not (entirely) removed during the first surgery, in highly myopic as well as in emmetropic eyes. 6 …”

Section: Introductionmentioning

confidence: 99%

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The role of vitreous cortex remnants in proliferative vitreoretinopathy formation demonstrated by histopathology: A case report

Overdam

Busch

Verdijk

et al. 2021

American Journal of Ophthalmology Case Reports

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Purpose The pathogenesis of proliferative vitreoretinopathy (PVR), the most important cause of retinal detachment surgery failure, is still not fully understood. We previously hypothesized a causal link between vitreoschisis-induced vitreous cortex remnants (VCR) and PVR formation. The purpose of this case report is to demonstrate this association by showing the clinical occurrence of PVR in the presence of VCR across the retinal surface, illustrated by histopathological analysis. Observations A 69-year-old male was referred because of widespread epiretinal membrane formation after treatment of recurrent retinal detachments. During surgery with extensive membrane peeling, a large continuous membrane was peeled from the superior arcade towards the inferior temporal mid-periphery. Histopathological analysis of this membrane revealed areas with different characteristics: paucicellular laminar collagen-rich areas, suggestive for VCR, areas with increased cellularity, and more fibrotic areas with low cellularity. The immunohistochemical analysis identified cell type variety in these areas: collagen-rich areas showed glial cells and hyalocytes, while in areas with high cellularity fibroblasts, macrophages and retinal pigment epithelial cells were found, which have previously been shown to play an important role in the development of PVR as they can transdifferentiate into myofibroblasts, which were seen in the more fibrotic areas. Conclusions and importance These findings support the theory that VCR have a role in PVR development, where VCR can act as a scaffold for fibrocellular proliferation. We suggest that the presence of VCR over the retinal surface should be qualified as a risk factor for PVR formation. Detection and adequate removal of VCR may improve the success rate of retinal detachment surgery.

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Section: Introductionmentioning

confidence: 47%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The role of vitreous cortex remnants in proliferative vitreoretinopathy formation demonstrated by histopathology: A case report

Overdam

Busch

Verdijk

et al. 2021

American Journal of Ophthalmology Case Reports

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“…Furthermore, in young phakic patients, partial vitreous detachment or vitreoschisis may be present, thereby making complete vitreous cortex removal from the retinal surface more difficult. This might lead to an increased risk of redetachment, possibly involving the vitreous cortex remnants acting as a scaffold for proliferative vitreoretinopathy (PVR) (Kuhn & Aylward 2014; van Overdam 2020). Other possible surgical options for SBRD are pneumatic retinopexy (PR) and the D‐ACE (fluid drainage (D), followed by intravitreal injection of air (A), transcleral cryopexy (C), and episcleral explant (E)) sequence.…”

Section: Introductionmentioning

confidence: 99%

Pneumatic retinopexy preceded by drainage of subretinal fluid for the treatment of severe bullous retinal detachment

Morescalchi

Russo

Gandolfo

et al. 2020

Acta Ophthalmologica

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Purpose To compare the efficacy and safety outcomes of scleral buckling (SB) and drainage–injection–pneumoretinopexy (DIP), a modified pneumatic retinopexy technique, in which, before gas injection, subretinal fluid is drained with a simultaneous injection of balanced salt solution (BSS) in the vitreous chamber, for the treatment of severe superior bullous rhegmatogenous retinal detachment (SBRD). Methods This prospective, randomized, comparative study included 58 eyes with severe SBRD that were randomized 1:1 to undergo SB or DIP. The main outcome measures included success rate, visual acuity, mean change in refractive error and surgery duration. Results The primary anatomic success rate was 93% for both procedures. Both groups showed significantly improved visual acuity after surgery. The change in refractive error and surgery duration was significantly higher in the SB group. Drainage–injection–pneumoretinopexy (DIP) appeared to be less traumatic, but with a longer persistence of subretinal fluid in a greater number of patients. Conclusion Our findings suggested that both SB and DIP are safe and effective treatments yielding functional and anatomical recovery in patients with severe SBRD. However, the DIP technique may be easier and less costly, with a success rate similar to that of SB.

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Rhegmatogenous Retinal Detachment

Lee¹,

Byon

Park

2020

Internal Limiting Membrane Surgery

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Vitreoschisis‐induced vitreous cortex remnants: missing link in proliferative vitreoretinopathy

Cited by 28 publications

References 7 publications

The role of vitreous cortex remnants in proliferative vitreoretinopathy formation demonstrated by histopathology: A case report

The role of vitreous cortex remnants in proliferative vitreoretinopathy formation demonstrated by histopathology: A case report

Pneumatic retinopexy preceded by drainage of subretinal fluid for the treatment of severe bullous retinal detachment

Rhegmatogenous Retinal Detachment

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