Diagnostic Sonography • B-Scan Eye Pathology Atlas
Proliferative Vitreoretinopathy (PVR)
A structured ocular ultrasound case collection covering sonographically recognizable patterns of proliferative vitreoretinopathy, including vitreoretinal membranes, retinal folds, tractional configuration and associated retinal detachment.
Proliferative Vitreoretinopathy — Sonographic Morphology Index
01
Early / Fine Vitreoretinal Membrane Formation
→
02
Focal Contractile Vitreoretinal Membrane
→
03
Star-Fold / Radial Retinal Folds
→
04
Tractional Retinal Detachment with PVR
→
05
Funnel-Shaped Retinal Detachment with PVR
→
06
Extensive Circumferential PVR
→
07
Advanced PVR with Fixed / Contracted Retina
→
Chapter 01 • Case Study
Early / Fine Vitreoretinal Membrane Formation
01 Clinical History
Patient with previous or suspected retinal detachment and
concern for proliferative vitreoretinopathy. B-scan is
performed to evaluate subtle vitreoretinal membranes and
early tractional changes.
02 Ultrasound Image
03 Ultrasound Morphology
| Feature | Sonographic Description |
|---|---|
| Membrane | Fine linear or sheet-like echogenic vitreoretinal membrane may be visualized. |
| Configuration | Thin membrane may follow or distort the retinal contour. |
| Mobility | Mobility may be reduced where traction is present. |
| Retina | Evaluate for pre-existing or recurrent retinal detachment. |
| Extent | Assess the membrane throughout the vitreous cavity using multiple scan planes. |
04 Ultrasound Report
Fine echogenic vitreoretinal membrane formation is
demonstrated.
The membrane demonstrates reduced mobility in areas of
suspected vitreoretinal traction.
Associated retinal contour abnormality should be
correlated with dynamic examination.
05 Impression
Sonographic Impression
Fine vitreoretinal membrane formation, suspicious for
early proliferative vitreoretinopathy.
06 Recommendation
Correlate with previous retinal surgery or retinal
detachment history. Detailed ophthalmic retinal evaluation
is recommended.
07 Learning Points
Look carefully for fine vitreoretinal membranes.
Assess membrane mobility dynamically.
Search for early retinal traction.
Evaluate for associated retinal detachment.
Chapter 02 • Case Study
Focal Contractile Vitreoretinal Membrane
01 Clinical History
Patient with previous retinal pathology and suspected
focal traction. B-scan demonstrates a localized contractile
vitreoretinal membrane producing distortion of the retinal
contour.
02 Ultrasound Image
03 Ultrasound Morphology
| Feature | Sonographic Description |
|---|---|
| Membrane | Localized echogenic membrane adherent to or associated with the retinal surface. |
| Traction | Membrane contraction may produce focal retinal tenting or distortion. |
| Mobility | The contracted portion may demonstrate limited mobility. |
| Contour | Retinal contour may become irregular or focally elevated. |
| Differential | Distinguish tractional membrane from an independently mobile detached retina. |
04 Ultrasound Report
Focal echogenic vitreoretinal membrane is demonstrated.
Associated focal retinal contour distortion is noted.
The abnormal membrane demonstrates limited mobility,
compatible with tractional change.
05 Impression
Sonographic Impression
Focal contractile vitreoretinal membrane with tractional
retinal distortion, compatible with PVR-related change.
06 Recommendation
Correlate with retinal examination and history of prior
retinal detachment or vitreoretinal surgery.
07 Learning Points
Identify focal membrane formation.
Look for focal retinal tenting or distortion.
Assess membrane mobility.
Search for additional tractional membranes.
Chapter 03 • Case Study
Star-Fold / Radial Retinal Folds
01 Clinical History
Patient with suspected advanced vitreoretinal traction.
Dynamic B-scan demonstrates irregular retinal folds and
tractional distortion.
02 Ultrasound Image
03 Ultrasound Morphology
| Feature | Sonographic Description |
|---|---|
| Retinal folds | Multiple irregular folds or ridges involving the detached or tractionally distorted retina. |
| Configuration | Radial, circumferential or star-like configuration may be seen. |
| Traction | Contractile membranes may produce inward traction and retinal shortening. |
| Mobility | Mobility may be restricted compared with uncomplicated retinal detachment. |
| Extent | Assess the involved quadrants and posterior pole. |
04 Ultrasound Report
Multiple irregular retinal folds are demonstrated.
The retinal contour is distorted with reduced mobility.
Associated vitreoretinal tractional membranes are
suspected.
05 Impression
Sonographic Impression
Irregular tractional retinal folds compatible with
proliferative vitreoretinopathy.
06 Recommendation
Ophthalmic retinal assessment is recommended to determine
the extent and severity of tractional disease.
07 Learning Points
Recognize irregular retinal folds.
Assess the degree of retinal shortening and distortion.
Look for associated contractile membranes.
Document the posterior extent.
Chapter 04 • Case Study
Tractional Retinal Detachment with PVR
01 Clinical History
Patient with known or suspected retinal detachment and
vitreoretinal proliferative changes. B-scan is performed
to characterize the detached retina, tractional membranes
and mobility.
02 Ultrasound Image
03 Ultrasound Morphology
| Feature | Sonographic Description |
|---|---|
| Retinal detachment | Detached retina demonstrates irregular or tented configuration. |
| Traction | Echogenic membranes may pull the retina toward the vitreous cavity. |
| Mobility | Retinal movement is often restricted by traction. |
| Contour | Irregular, folded or concave retinal configuration may be present. |
| Optic disc | Evaluate posterior retinal attachment where technically possible. |
04 Ultrasound Report
Retinal detachment is demonstrated with associated
irregular tractional membrane formation.
The detached retina demonstrates reduced mobility,
consistent with tractional restriction.
Findings are suggestive of proliferative vitreoretinopathy
associated with retinal detachment.
05 Impression
Sonographic Impression
Tractional retinal detachment with associated
proliferative vitreoretinopathy.
06 Recommendation
Prompt vitreoretinal specialist assessment is recommended.
Document the extent, configuration and posterior retinal
attachment.
07 Learning Points
Look for restricted retinal mobility.
Identify tractional membranes.
Assess retinal contour and folding.
Document retinal extent and optic-disc attachment.
Chapter 05 • Case Study
Funnel-Shaped Retinal Detachment with PVR
01 Clinical History
Patient with advanced retinal detachment and suspected
proliferative vitreoretinopathy. B-scan demonstrates a
contracted retinal configuration with narrowing toward
the posterior pole.
02 Ultrasound Image
03 Ultrasound Morphology
| Feature | Sonographic Description |
|---|---|
| Configuration | Contracted retinal detachment forms a funnel-like configuration. |
| Traction | Contractile membranes exert traction toward the posterior vitreous cavity. |
| Mobility | Retinal movement is markedly restricted. |
| Posterior pole | Evaluate the relationship of the contracted retina to the optic disc. |
| Extent | Document the degree of peripheral and posterior involvement. |
04 Ultrasound Report
Contracted retinal detachment demonstrates a
funnel-shaped configuration.
Retinal mobility is markedly restricted.
Associated echogenic tractional membranes are
demonstrated.
05 Impression
Sonographic Impression
Funnel-shaped tractional retinal detachment with advanced
proliferative vitreoretinopathy.
06 Recommendation
Urgent vitreoretinal specialist evaluation is recommended.
Document posterior retinal configuration and optic-disc
relationship.
07 Learning Points
Recognize funnel-shaped retinal configuration.
Assess the degree of retinal contraction.
Evaluate posterior retinal attachment.
Look for extensive tractional membranes.
Chapter 06 • Case Study
Extensive Circumferential PVR
01 Clinical History
Patient with extensive retinal proliferative disease and
previous retinal detachment. B-scan is performed to define
the distribution of tractional membranes and retinal
contraction.
02 Ultrasound Image
03 Ultrasound Morphology
| Feature | Sonographic Description |
|---|---|
| Extent | Tractional membranes involve multiple retinal quadrants. |
| Configuration | Extensive irregular retinal folds and contracted retinal contour. |
| Membranes | Broad or multiple echogenic vitreoretinal membranes may be visualized. |
| Mobility | Markedly reduced retinal mobility may occur. |
| Posterior pole | Carefully evaluate the posterior retina and optic-disc relationship. |
04 Ultrasound Report
Extensive vitreoretinal membrane formation involves
multiple retinal sectors.
Associated retinal contraction and irregular folding are
demonstrated.
Retinal mobility is markedly restricted.
05 Impression
Sonographic Impression
Extensive proliferative vitreoretinopathy with
circumferential tractional retinal changes.
06 Recommendation
Vitreoretinal specialist assessment is recommended.
Document all involved sectors and posterior retinal
configuration.
07 Learning Points
Determine the full extent of membrane formation.
Evaluate retinal contraction in multiple planes.
Assess retinal mobility dynamically.
Evaluate the posterior pole and optic disc.
Chapter 07 • Case Study
Advanced PVR with Fixed / Contracted Retina
01 Clinical History
Patient with advanced proliferative vitreoretinal disease
and severely restricted retinal mobility. B-scan is
performed to evaluate the fixed retinal configuration,
tractional membranes and posterior pole involvement.
02 Ultrasound Image
03 Ultrasound Morphology
| Feature | Sonographic Description |
|---|---|
| Retina | Markedly contracted and irregular retinal configuration. |
| Mobility | Very limited or absent retinal movement on dynamic examination. |
| Membranes | Dense echogenic vitreoretinal membranes may surround or distort the retina. |
| Configuration | Funnel-shaped, folded or closed configuration may be present. |
| Posterior pole | Evaluate the relationship of the contracted retina to the optic disc. |
04 Ultrasound Report
Dense echogenic vitreoretinal membranes with severe
retinal contraction are demonstrated.
The retinal complex demonstrates markedly restricted
mobility.
The configuration is compatible with advanced tractional
retinal disease.
05 Impression
Sonographic Impression
Advanced proliferative vitreoretinopathy with severely
contracted and relatively fixed retinal configuration.
06 Recommendation
Prompt vitreoretinal specialist evaluation is recommended.
Correlate with prior retinal surgery, detachment history
and current clinical findings.
07 Learning Points
Recognize severely contracted retinal configuration.
Assess retinal mobility dynamically.
Identify dense vitreoretinal membranes.
Document posterior pole involvement and optic-disc
relationship.
×
![Ultrasound enlarged image]()
No comments:
Post a Comment