TRD in patients with resolved candida chorioretinitis is usually associated with epiretinal membranes. These membranes may be the result of inflammation and vitreous traction and are located over the macular area.1
No dense fibrovascular membranes were identified in our patient. The posterior hyaloid remained attached to the chorioretinal scar. This adhesion results from cell migration and proliferation in the vitreous during active infection. TRD may appear when the vitreous traction force is stronger than the retinal–early receptor potential layer adhesion. Increased blood components or inflammatory cells induce vitreous gel shrinkage. Concurrence of strong vitreoretinal adhesion and vitreous shrinkage produces a partial PVD with a thickened posterior vitreous cortex.3
Detecting this type of PVD in patients with resolved Candida infection may alert the physician to the possible appearance of a TRD.
The location of the chorioretinal scar probably influences the appearance of these TRDs. Major retinal blood vessels are areas of relatively firm attachment of the vitreous to the retina.4
When the inflammatory focus is located over a vascular arcade, as in our case, PVD may be the main contributory cause.
- Slowly progressive combined traction and rhegmatogenous retinal detachment as a result of a candida chorioretinitis is a potentially serious complication.
- Ophthalmologists should be aware of this unusual complication after resolution of active candida chorioretinitis.
- Vitrectomy is mandatory if progression of combined retinal detachment is documented in order to avoid loss of vision.