PMC6854912_01
Multimodal imaging of a macula-threatening, diabetic, tractional retinal detachment in a 58-year-old male. (a) Preoperative fundus photograph showing extensive tractional membranes around the optic disc. (b) A spectral-domain optical coherence tomography (SD-OCT) scan through the fovea demonstrates the extent of retinal detachment (arrows). (c) and (d) Persistent subfoveal detachment at 6 months postoperatively (arrows and arrowheads). The extent of internal limiting membrane (ILM) peeling is marked (black dotted line). (e) and (f) Completely reattached retina at 1 month after secondary surgery with ILM peeling.
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fig1
Fundus examination revealed severe fibrovascular proliferation around the optic disc and superior temporal vascular arcade of right eye (Figure 1(a)). The fovea was dragged nasally due to tractional membranes and detached on SD-OCT (Figure 1(b)). Focal and thin epiretinal membrane was shown at the edge of the optic disc on OCT (Figure 1(d)). However, the presence of a tractional force was suspected, given the severely distorted superior retinal vasculature and significant dragging of the outer retinal tissue at the margin of the PSF (Figures 1(c) and 1(d)). After 1 month, the retina was completely reattached, and the previously distorted retinal vasculature was significantly straightened (Figures 1(e) and 1(f)).
PMC6854912_02
A 41-year-old female with tractional retinal detachment (TRD) involving the fovea of the left eye. (a),(b), and (c) Preoperative fundus photograph and SD-OCT images. (d), (e), and (f) Persistent submacular fluid at 4 months postoperatively (arrows and arrowheads). Extensive ILM peeling was performed (black dotted line). (g) At 1 month after wide ILM peeling, the retina was completely reattached.
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fig2
Diffuse tractional membranes extended along the major vascular arcades (Figure 2(a)), and extensive subretinal fluid and a subhyaloid hemorrhage were detected on the macula on SD-OCT examination (Figures 2(b) and 2(c)). During 4 months of postoperative follow-up, the PSF did not decrease on SD-OCT, and the logMAR BCVA remained at 1.40 (Snellen 20/500) (Figures 2(d) and 2(e)). Extensive ILM peeling including over the entire posterior pole was performed to cover the detached retina (Figure 2(d)). At the 1-month follow-up, the fovea was totally reattached on SD-OCT (Figure 2(f)) and the final logMAR BCVA improved to 0.70 (Snellen 20/100) at 1 month and maintained until 18 months postoperatively.