Pathogenesis and therapy of traction detachment in various retinal vascular diseases

We examined six patients with retinal vasculopathies (two cases each of angiomatosis retinae [von Hippel-Lindau disease], exudative vitreoretinopathy, and Coats' disease), who developed preretinal and vitreal membranes, retinal traction detachment, and exudation under the retina. The membranes consisted of a core of collagen of various diameter fibers usually covered on both sides by cells that displayed glial cell characteristics. The retina reattached spontaneously and exudates disappeared when traction was eliminated by vitreous surgery. Membrane formation did reoccur after vitrectomy if the vessels continued to leak, leading again to traction and subretinal exudation. Treatment consisted of surgical removal of vitreal and preretinal membranes and destruction of leaking vessels.