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Proliferative vitreoretinopathy (PVR) significantly impacts the prognosis of rhegmatogenous retinal detachment (RRD), one of the most critical and increasing causes of vision loss in the Western world. Despite advancements in surgical instruments and techniques, the failure rate due to PVR remains substantial, necessitating additional surgeries and often leading to unsatisfactory visual outcomes. This comprehensive review explores the role of vitreoschisis‐induced vitreous cortex remnants (VCR) as a critical, previously under‐recognised factor contributing to PVR. Vitreoschisis, a phenomenon where the inner lamellae of the posterior vitreous cortex detach while the outermost layers remain attached to the retina, creates VCR that may contain hyalocytes and serve as scaffolds for fibrocellular proliferation. These remnants are difficult to visualise without triamcinolone acetonide (TA) staining, leading to their frequent lack of recognition in clinical practice. Moreover, removing VCR can be challenging and time‐consuming, often requiring meticulous surgical techniques to avoid retinal damage and ensure complete elimination. This review consolidates insights from basic research and clinical practice, emphasising the importance of complete vitreous removal and effective VCR detection and removal to mitigate PVR risks. It highlights the histopathological and clinical evidence supporting the hypothesis that VCR, containing hyalocytes, play a pivotal role in preretinal membrane formation. The review also discusses epidemiological data, surgical management strategies and potential future directions, including improved visualisation techniques and the development of new surgical tools and methods. This review aims to improve surgical outcomes and reduce the frequency and burden of RRD‐related complications by addressing VCR as a critical factor in PVR. [ABSTRACT FROM AUTHOR]

Purpose: Unremoved vitreoschisis‐induced vitreous cortex remnants over the peripheral retinal surface posterior to the vitreous base (pVCR) may increase the risk of surgical failure after primary rhegmatogenous retinal detachment (RRD) repair. The purpose of this study was to validate our previous findings on pVCR prevalence during vitrectomy for RRD and to examine their association with proliferative vitreoretinopathy (PVR) and surgical failure. Methods: Prospective observational multisurgeon study of 100 eyes of 100 consecutive patients who underwent vitrectomy for RRD by one of four vitreoretinal surgeons. Collected data included detected pVCR and known PVR risk factors. Pooled analysis with our previous retrospective study (251 eyes of 251 patients) was also performed. Results: Initial PVR (≥C) was present and removed in 6/100 (6%) patients, pVCR were detected in 36/100 (36%) patients, pVCR were removed in 30/36 (83%) patients with pVCR, and 4/36 (11%) patients with pVCR were high myopes (≤−6D). Six per cent (6/100) developed a retinal redetachment, of which 3/6 (50%) had initial PVR (≥C). Surgical failure rates in eyes with and without pVCR were 17% (6/36) and 0% (0/64), respectively. In eyes with pVCR and surgical failure, pVCR were not or not completely removed during the first surgery. Overall analysis showed that pVCR were statistically significantly associated with PVR. Conclusions: This study confirms our previous findings: a pVCR prevalence of around 35% and an association between pVCR, PVR formation and surgical failure in patients undergoing vitrectomy for RRD. More research is needed to determine which patients would benefit most from pVCR removal. [ABSTRACT FROM AUTHOR]

Purpose: We evaluated the accuracy of a recently developed fundus image registration method (Weighted Vasculature Registration, or WeVaR) and compared it to two top-ranked state-of-the-art commercial fundus mosaicking programs (i2k Retina, DualAlign LLC, and Merge Eye Care PACS, formerly named OIS AutoMontage) in the context of diabetic retinopathy (DR) screening., Methods: Fundus images of 70 diabetic patients who visited the Rotterdam Eye Hospital in 2012 and 2013 for a DR screening program were registered by all three programs. The registration results were used to produce mosaics from fundus photos that were normalized for luminance and contrast to improve the visibility of small details. These mosaics subsequently were evaluated and ranked by two expert graders to assess the registration accuracy., Results: Merge Eye Care PACS had high registration failure rates compared to WeVaR and i2k Retina (P = 8 × 10(-6) and P = 0.002, respectively). WeVaR showed significantly higher registration accuracy than i2k Retina in intravisit (P ≤ 0.0036) and intervisit (P ≤ 0.0002) mosaics. Therefore, fundus mosaics processed by WeVaR were more likely to have a higher score (odds ratio [OR] = 2.5, P = 10(-5) for intravisit and OR = 2.2, P = 0.006 for intervisit mosaics). WeVaR was preferred more often by the graders than i2k Retina (OR = 6.1, P = 7 × 10(-6))., Conclusions: WeVaR produced intra- and intervisit fundus mosaics with higher registration accuracy than Merge Eye Care PACS and i2k Retina. Merge Eye Care PACS had higher registration failures than the other two programs. Highly accurate registration methods, such as WeVaR, may potentially be used for more efficient human grading and in computer-aided screening systems for detecting DR progression., (Copyright 2015 The Association for Research in Vision and Ophthalmology, Inc.)