Postoperative Macular Proliferative Vitreoretinopathy: A Case Series and Literature Review

Abstract

Premacular membranes developing following pars plana vitrectomy (PPV) can cause significant anatomical and functional deficits to the macula. Recent reports showed that postoperative premacular membranes are a localized presentation of macular proliferative vitreoretinopathy (mPVR). Here, we report retrospectively a case series of 5 patients with severe mPVR which developed following uneventful PPV and were followed up to 32 months in the Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, between October 2016 and February 2020. All patients underwent primary repair of rhegmatogenous retinal detachment (RRD) before mPVR developed. Mean best-corrected visual acuity (BCVA) at presentation was 20/76 Snellen (0.58 LogMAR). Median duration of the retinal detachment time until surgery was 1.5 days (range 1–21 days). Mean interval time from last normal follow-up exam to diagnosis of mPVR was 19 days (range 10–28). BCVA dropped from a mean of 20/38 Snellen (0.28 LogMAR) prior to mPVR development to 20/166 Snellen (0.92 LogMAR) following its development, recovering to 20/57 Snellen (0.45 LogMAR) after peeling of membranes. Mean central macular thickness measured by optical coherence tomography decreased from 711 to 354 μm postsurgery. In conclusion, short-term mPVR is a different entity from macular pucker in terms of rapid development, structural distortion, and visual compromise. Surgical treatment significantly restores macular function and anatomy.

Experimental Models to Study Epithelial-Mesenchymal Transition in Proliferative Vitreoretinopathy

“…However, the injection of exogenous cells bearing foreign antigens as well as the rapid disease development must be taken in account before selecting this type of model [76]. Some proliferative retinal diseases such as macular PVR and post-traumatic PVR can have a rapid onset and be simulated by the injection models [135]. However, other proliferative retinal diseases linked to chronic pathologies such as proliferative diabetic retinopathy and exudative age-related macular degeneration can take years for proliferation to be clinically apparent and thus cannot be accurately reproduced by these models.…”