Purpose: To determine the relationship between 'pigment clusters' on blood vessels (BvRPE) on the inferior retina in patients with rhegmatogenous retinal detachment, and existing proliferative vitreoretinopathy (PVR).
Methods: A prospective observational non-comparative study of consecutive patients presenting with rhegmatogenous retinal detachment to a tertiary referral university department was performed. The retina was inspected preoperatively for the detection of BvRPE. A relationship with existing PVR was determined.
Results: A total of 103 patients were recruited, 70 men and 32 women, mean age 56.7 years, with 57 left eyes. Mean duration of follow up was 9.2 months. Nineteen patients (18.4%) had BvRPE, and 20 had RPE clusters off blood vessels (nine had both). In those with the sign of BvRPE the mean number of RPE clusters on blood vessels was 5.7 (SD 5.8). The mean number of clock hours affected was 2.32 (SD = 1.58). Eight had B grade PVR and three C grade PVR. Patients with BvRPE were more likely to have PVR grades B or C than those without the sign (P = 0.002). The mean number of operations in those with the sign was 1.32 (SD = 0.58) and was statistically similar to those without BvRPE. Visual outcome was statistically similar in those with and without the sign.
Conclusion: Patients with rhegmatogenous retinal detachment may demonstrate 'pigment clusters' on blood vessels in the inferior retina (BvRPE). This is likely to be a specific feature found in PVR and an early sign of activation of retinal pigment epithelial cells.