Macular reactivity following adjunctive PRGF in vitreomacular surgery with inflammatory predisposition

Plasma rich in growth factors (PRGF) has been used as an intraoperative biological adjunct in vitreomacular surgery to support structural repair. We report two cases of macular reactivity following PRGF application in eyes with underlying inflammatory priming. In the first case, a man with a history of intermediate uveitis underwent vitrectomy with fovea-sparing peeling and PRGF application for tractional foveoschisis. Postoperatively, transient contractile macular changes were observed, which regressed spontaneously, and anatomical stability was maintained. In the second case, a woman with rheumatoid arthritis and proliferative vitreoretinopathy underwent repeat surgery with PRGF for a persistent macular hole. One month later, marked macular oedema developed, requiring escalation of anti-inflammatory therapy. These cases raise the possibility that adjunctive PRGF may contribute to postoperative macular reactivity in eyes with underlying inflammatory predisposition, underscoring the need for careful patient selection and close postoperative monitoring.