Anterior PVR Part II: Clinicopathologic, Light Microscopic, and Ultrastructural Findings

Up to 10% of rhegmatogenous retinal detachments are complicated by proliferative vitreoretinopathy (PVR), which leads to failure of retinal detachment repair. A related more anterior process, though less well defined clinicopathologically, has been described clinically. Termed anterior loop traction,1 peripheral proliferative vitreoretinopathy (PPVR)2, or anterior proliferative vitreoretinopathy (APVR)3,4 (also see Part I of this chapter) on clinical bases, this process complicates rhegmatogenous retinal detachments, though less frequently than PVR. Adherent APVR membranes and vitreous extend from the peripheral retina near the vitreous base to the ciliary body, iris, or pupillary margin. APVR membrane and vitreous contraction pull the peripheral retina anteriorly, thereby producing a circumferential retinal fold with a trough of variable depth and width between the circumferential retinal fold and the pars plana of the ciliary body.1,3,4 (Part I) Circumferential contraction produces radial retinal folds extending posteriorly and from the circumferential retinal fold.4 (Part I)