Histology and therapy of diabetic traction detachment

Abstract

Diabetic tractional detachment of the retina is caused by shrinking processes of the vitreous, which at most detaches only partially, and by shrinking of epiretinal proliferations. The shrinking of the vitreous results in tractional forces working centripetally and toward the base of the vitreous. The shrinking of the epiretinal proliferations, however, results in a tangential gathering of the retina. The two processes are usually found together in diabetic tractional retinal detachment. Treatment consists of a vitrectomy to eliminate the centripetal forces and tractions to the vitreous base. Further relief and unfolding of the retina is achieved by segmentation of the epiretinal membranes. Additional conventional retinal surgery procedures and implantation of silicone oil may become necessary in especially unfavorable cases. The surgical technique is explained with examples of typical situations.