Chronic Retinal Detachment with Active Preretinal Hemorrhage

The patient shown here is a 34-year-old female patient with a chronic inferotemporal retinal detachment of the right eye. She was hit by a rock in the right eye at age 4. The yellow arrows show preretinal hemorrhage associated with secondary neovascularization, which can follow chronic retinal detachment. Over the course of a year of follow-up, the amount of preretinal hemorrhage increased. As a result, after the 2019 visit, surgical repair was recommended. However, she elected continued observation, and follow-up was scheduled for 6 months or at any time that symptoms developed. Chronic retinal detachment produces retinal ischemia of the detached portion of the retina with upregulation of VEGF, which in turn causes fragile new vessels to grow that can break and bleed, as in this case.