PMC5778555_01
Intraoperative photograph of the left eye of a patient with B-cell acute lymphoblastic leukemia with proliferative retinopathy. After clearing the vitreous hemorrhage, fluid-air exchange is being done. Inferotemporal large area of subretinal exudation can be noted
IJO-66-148-g001.jpg
PMC5778555_01_IJO-66-148-g001.jpg
F1
Vascular attenuation, pallid edema of the retina, and a six-disc diameter area of subretinal exudation along with hemorrhage along the inferotemporal arcade were noted intraoperatively [Fig. 1].
Two-month postoperative condition of the left eye. (a) 45  fundus photograph showing vascular attenuation, resolving subretinal exudates at macula and inferotemporal area of retinal traction with overlying fibrous proliferation. (b) Inferotemporal area of resolving subretinal infiltrates and hemorrhage is evident on ultra-wide-field photography. (c) Swept source optical coherence tomography vertical line scans at fovea show inner retinal edema along with subinternal limiting membrane clear cavity inferiorly. (d) Absence of neovascularization on wide-field fluorescein angiography with window defects of laser scars inferotemporally
IJO-66-148-g002.jpg
PMC5778555_01_IJO-66-148-g002.jpg
F2
Subretinal exudation and hemorrhage decreased in the left eye over time and visual acuity improved to 20/120 [Fig. 2a and b]. Swept source optical coherence tomography (OCT, Topcon Inc.,) showed macular thickening with inner retinal hyperreflectivity suggestive of edema [Fig. 2c]. Ultra-wide-field fundus fluorescein angiography (Optos Inc.,) done in the left eye 2 months after the PPV did not show active neovascularization at disc or elsewhere [Fig. 2d].
Intraoperative photographs of pars plana vitrectomy in the right eye. (a) Nasal fibrous proliferation with underlying tractional retinal detachment can be seen. Membrane peeling was done. (b) Shows the condition after fluid-air exchange with relieved retinal traction
IJO-66-148-g003.jpg
PMC5778555_01_IJO-66-148-g003.jpg
F3
Fibrovascular proliferation leading to tractional retinal detachment and peripheral subretinal exudation was noted in the nasal area [Fig. 3a and b].
Color photograph at final follow-up in the right eye (a) shows nasal disc drag and scatter laser photocoagulation scars. Swept source optical coherence tomography through the fovea (b) shows a near normal foveal contour in the right eye. Color picture of the left eye (c) shows resolved subretinal exudates and hemorrhage inferotemporally. (d) Shows persistent subinternal limiting membrane cavity on swept source optical coherence tomography inferiorly with retinal edema
IJO-66-148-g004.jpg
PMC5778555_01_IJO-66-148-g004.jpg
F4
Following surgery and chemotherapy, proliferative retinopathy regressed in both eyes over time [Fig. 4].