Proliferative Diabetic Retinopathy - Traction Retinal Detachment
In proliferative diabetic retinopathy, abnormal new blood vessels grow out of the retina into the vitreous where they establish firm connections with the collagen fibrils. As the vessels mature they lay down fibrous scar tissue that is much stronger than the retina. Over time the vitreous gel can contract and transmit the force of contraction through the scar tissue to the underlying retina. If severe enough, the retina may detach under the influence of this traction. In the photo shown, the edge of the detached retina is marked by yellow arrows. To relieve the traction, vitrectomy surgery is performed in which the vitreous gel is cut away and the fibrous scar bands are severed. The resected vitreous is replaced with a physiological saline solution. Once the scars are removed the retina can settle back into its accustomed position and the vision lost in the area of detachment can be partially restored.