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Bulgarian Review of Ophthalmology

Combined tractional rhegmatogenous retinal detachment in vascular occlusive disease

Gergana Stoilova, Ilian Shandurkov


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.


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

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Hsu YJ, Hsieh YT, Yeh PT, Huang JY, Yang CM. Combined tractional and rhegmatogenous retinal detachment in proliferative diabetic retinopathy in the anti-VEGF era. J Ophthalmol. 2014;2014:917375. doi: 10.1155/2014/917375.

de Carlo TE, Romano A, Waheed NK, Duker JS. A review of optical coherence tomography angiography (OCTA). Int J Retina Vitreous. 2015;1:5. doi: 10.1186/s40942-015-0005-8

Gao SS, Liu G, Huang D, Jia Y. Optimization of the split-spectrum amplitude-decorrelation angiography algorithm on a spectral optical coherence tomography system. Opt Lett. 2015 May 15;40(10):2305-8. doi: 10.1364/OL.40.002305.

Singh M, Dhir L, Kon C, Rassam S. Tractional retinal break and rhegmatogenous retinal detachment consequent to branch retinal vein occlusion. Eye (Lond). 2006;20(11):1326-7. doi: 10.1038/sj.eye.6702195

Joondeph HC, Goldberg MF. Rhegmatogenous retinal detachment after tributary retinal vein occlusion. Am J Ophthalmol. 1975;80(2):253-7.

Joondeph HC, Joondeph BC. Posterior tractional retinal breaks complicating branch retinal vein occlusion. Retina. 1988; 8(2):136-40.

Chess J, Eichen AL. Rhegmatogenous retinal detachment associated with branch vein occlusion. Ann Ophthalmol. 1989; 21(8):309-11.

Jalkh A, Takahashi M, Topilow HW Trempe CL, McMeel JW. Prognostic value of vitreous findings in diabetic retinopathy. Arch Ophthalmol. 1982; 100(3):432-4.

Kir E, Saatci AO, Ozbek Z, Kaynak S, Ergin MH. Retinal breaks and rhegmatogenous retinal detachment in association with branch retinal vein occlusion. Ophthalmic Surg Lasers. 1999; 30(4): 285-8.



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About The Authors

Gergana Stoilova
Vision Eye Clinic, Sofia, Bulgaria

Ilian Shandurkov
Vision Eye Clinic, Sofia, Bulgaria