case_images: PMC11417017_01
case_images: Preoperative examination of Patient 1. (A) Ultra-widefield fundus photography of the right eye revealed vast preretinal hemorrhage in the posterior polar and superior regions, together with scattered intraretinal hemorrhage spots and asteroid hyalosis in the periphery. (B) Ultra-widefield fundus photography of the left eye revealed microaneurysms and retinal hemorrhage in all quadrants of the fundus as well as a few hard exudates in the posterior polar retina. (C) Ultrasound of the right eye revealed vitreous opacity and tractional retinal detachment.
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case_images: fig1
case_images: Fundus examination of the right eye revealed vast preretinal hemorrhage in the posterior polar and superior regions, together with scattered intraretinal hemorrhage spots and asteroid hyalosis in the periphery (Figure 1A). Microaneurysms and retinal hemorrhage in all quadrants of the fundus as well as a few hard exudates in the posterior polar retina were observed in the left eye (Figure 1B). Ultrasound revealed vitreous opacity and tractional retinal detachment (TRD) in the right eye (Figure 1C). Interestingly, rapid movement of tiny white thrombi was observed in the superotemporal branch of the central retinal vein at the time of fibrovascular membrane delamination (shown in Figure 2 and Supplementary Video S1).
case_images: Intraoperative observation of migratory retinal venous thrombus in Patient 1. Rapid movement of tiny white thrombi was observed in the superotemporal branch of the central retinal vein at the time of fibrovascular membrane delamination. The upper two images displayed the full view, while the lower two images displayed the magnified view. Red arrows indicated the migratory retinal venous thrombus.
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case_images: fig2
case_images: It is worth mentioning that white migratory thrombi with a similar diameter to the vessel were observed twice in a branch retinal vein during fibrovascular membrane delamination, with a duration of approximately 2-3 s each time, similar to that in Patient 1 (shown in Figure 4A and Supplementary Video S2).
case_images: PMC11417017_02
case_images: Intraoperative observation of migratory retinal venous thrombus in Patient 1. Rapid movement of tiny white thrombi was observed in the superotemporal branch of the central retinal vein at the time of fibrovascular membrane delamination. The upper two images displayed the full view, while the lower two images displayed the magnified view. Red arrows indicated the migratory retinal venous thrombus.
case_images: fmed-11-1372831-g002.jpg
case_images: PMC11417017_02_fmed-11-1372831-g002.jpg
case_images: fig2
case_images: It is worth mentioning that white migratory thrombi with a similar diameter to the vessel were observed twice in a branch retinal vein during fibrovascular membrane delamination, with a duration of approximately 2-3 s each time, similar to that in Patient 1 (shown in Figure 4A and Supplementary Video S2).
case_images: Preoperative examination of Patient 2. (A) Ultra-widefield fundus photography of the right eye revealed evident tractional retinal detachment with the involvement of the macular area, together with previous PRP spots in the periphery. (B) Ultra-widefield fundus photography of the left eye revealed previous PRP spots in the periphery. (C) Ultrasound of the right eye revealed evident tractional retinal detachment and slight hemorrhagic vitreous opacity. (D) OCT of the right eye revealed retinal detachment and epiretinal membrane in the macular area.
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case_images: PMC11417017_02_fmed-11-1372831-g003.jpg
case_images: fig3
case_images: She had phacoemulsification cataract extraction and IOL implantation in both eyes 10 years ago, and PRP in both eyes 8 years ago (Figures 3A,B). Evident tractional retinal detachment was observed in the right eye, with the involvement of the macular area (Figures 3A,C). OCT revealed retinal detachment and epiretinal membrane in the macular area (Figure 3D). Interruption of blood flow was also observed for three times with evident segmental whitening of the vein, which appeared when the membrane delamination began and disappeared immediately once the delamination stopped (shown in Figure 4B and Supplementary Video S3).
case_images: Intraoperative observation of migratory retinal venous thrombus and blood flow interruption in Patient 2. (A) White migratory thrombi with a similar diameter to the vessel were observed during fibrovascular membrane delamination. (B) Interruption of blood flow was observed with evident segmental whitening of the vein, which appeared during the process of membrane delamination. The upper images displayed the full view, while the lower images displayed the magnified view. Red arrows indicate the migratory retinal venous thrombus. Red arrowheads indicate blood flow interruption.
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case_images: PMC11417017_02_fmed-11-1372831-g004.jpg
case_images: fig4
case_images: It is worth mentioning that white migratory thrombi with a similar diameter to the vessel were observed twice in a branch retinal vein during fibrovascular membrane delamination, with a duration of approximately 2-3 s each time, similar to that in Patient 1 (shown in Figure 4A and Supplementary Video S2). Interruption of blood flow was also observed for three times with evident segmental whitening of the vein, which appeared when the membrane delamination began and disappeared immediately once the delamination stopped (shown in Figure 4B and Supplementary Video S3). Fluorescein fundus angiography (FFA) was carried out in both patients at 1 month postoperatively, which revealed normal venous filling without embolus sign in Patient 1 (Figure 7A and Supplementary Videos S4, S5) and delayed venous filling without embolus sign in Patient 2 (Figure 7B and Supplementary Videos S6, S7).
case_images: Postoperative examination of Patient 1 at 3 months. Anterior segment photography (A) revealed no positive findings. Ultra-widefield fundus photography (B) and ultrasound (C) revealed a well-attached retina.
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case_images: fig5
case_images: Examinations of Patient 1 demonstrated a well-attached retina (Figure 5) and improved BCVA at 3 months after surgery. Fluorescein fundus angiography (FFA) was carried out in both patients at 1 month postoperatively, which revealed normal venous filling without embolus sign in Patient 1 (Figure 7A and Supplementary Videos S4, S5) and delayed venous filling without embolus sign in Patient 2 (Figure 7B and Supplementary Videos S6, S7).
case_images: Postoperative examination of Patient 2 at 6 months. Anterior segment photography (A) revealed no positive findings. Slight local subretinal fluid was discovered by OCT (B), yet no obvious retinal detachment was detected according to ultra-widefield fundus photography (C) and ultrasound (D).
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case_images: fig6
case_images: Follow-up at 6 months postoperatively revealed that the slight local subretinal fluid remained, yet no obvious retinal detachment was detected by ultrasound (Figure 6). Fluorescein fundus angiography (FFA) was carried out in both patients at 1 month postoperatively, which revealed normal venous filling without embolus sign in Patient 1 (Figure 7A and Supplementary Videos S4, S5) and delayed venous filling without embolus sign in Patient 2 (Figure 7B and Supplementary Videos S6, S7).
case_images: FFA of Patients 1 and 2 at 1 month after surgery. (A) Venous phase (at 20 s) of FFA showed normal venous filling and no embolus sign in Patient 1. (B) Arteriovenous phase (at 22 s) of FFA showed delayed venous filling without embolus sign in Patient 2. Red arrow indicates the location of the superotemporal branch of the central retinal vein.
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case_images: PMC11417017_02_fmed-11-1372831-g007.jpg
case_images: fig7
case_images: Fluorescein fundus angiography (FFA) was carried out in both patients at 1 month postoperatively, which revealed normal venous filling without embolus sign in Patient 1 (Figure 7A and Supplementary Videos S4, S5) and delayed venous filling without embolus sign in Patient 2 (Figure 7B and Supplementary Videos S6, S7).