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Bulgarian Review of Ophthalmology

Combined tractional rhegmatogenous retinal detachment in vascular occlusive disease

Gergana Stoilova, Ilian Shandurkov

Abstract

Aim: The aim of this paper is to present a patient with combined tractional rhegmatogenous retinal detachment due to venous occlusion, method of treatment and post-treatment results.

Materials and Methods: We present a 61-year-old man with sudden loss of vision of the right eye. The same eye was treated few times conservatively (with laser therapy and medications) due to recurrent vitreous hemorrhage. The patient was not treated with any medications for any systematic disease. The choice of treatment was surgical: pars plana vitrectomy, endolaser and silicone oil tamponade.

Results: Combined tractional rhegmatogenous retinal detachment with occlusion of venous vessels was established intraoperatively. Pan-endolaser was performed and silicone oil tamponade was implanted in the eye. Postoperatively, visual acuity improved dramatically in a month - from 0.01 before, to 0.4 a day after surgery, to 0.8-1.0 a month after surgery.

Discussion: Since the retinal rupture is near the venous thrombosis, we can suggest that the rupture is due to vitreoretinal traction which, is a consequence of the occlusion and not vice versa. The grade of retinal ischemia is the main factor for late visual acuity.

Conclusion: Combined tractional rhegmatogenous retinal detachment due to venous thrombosis is a rare condition. The main purpose of the surgical treatment is to remove tractions and to treat retinal ischemia with laser photocoagulation. It is very important for the patient`s overall health to collaborate well with cardiologists and endocrinologists. The forecast for the patient`s visual acuity is good when the treatment is precise and timely.


Keywords

tractional; rhegmatogenous; retinal detachment; vessel occlusion; venous thrombosis; pars plana vitrectomy; retinal ischemia

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DOI: http://dx.doi.org/10.14748/bro.v0i2.5179

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About The Authors

Gergana Stoilova
Vision Eye Clinic, Sofia, Bulgaria
Bulgaria

Ilian Shandurkov
Vision Eye Clinic, Sofia, Bulgaria
Bulgaria

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