Tractional retinoschisis in proliferative diabetic retinopathy: a histopathological study.

BACKGROUND

Proliferative diabetic retinopathy (PDR) often results in a tractional elevation of the retina. This study investigates the anatomical and histopathological structures of the vitreous body and the elevated retina in PDR.

METHODS

Four globes (three patients) with PDR and known retinal elevation were analysed histologically. The tissues were embedded in celloidin and a special thick section technique (250 microm) was used for analysis under a stereomicroscope.

RESULTS

All four cases showed adherence of the vitreous body with the retina and a tractional elevation of the retina at that site. In two cases retinoschisis was combined with retinal detachment and in the other two cases the retinal elevation was a pure retinal schisis.

CONCLUSION

Our histopathological investigations of PDR show that traction of the retina by shrinking of the vitreous body may result in a combination of retinoschisis and retinal detachment at the same area. These cases are clinically often diagnosed as retinal detachment, but because of the additional retinal schisis they are of poor functional prognosis.