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Thus, even in persons with resolved or treated HBV, the cccDNA poses a permanent risk for reactivation, particularly in clinical settings associated with immunosuppression.[6] Clinical Features of HBV Reactivation The reactivation of HBV can result in manifestations that range in severity from silent reactivation, which is characterized by elevated HBV DNA but no overt signs of hepatitis, to HBV-associated hepatitis (with clinical, laboratory and histological evidence of hepatitis), and to fulminant liver failure, marked by synthetic dysfunction in conjunction with clinical symptoms, including ascites and encephalopathy.[2] These clinical and laboratory manifestations are not mutually exclusive but rather exist on a continuum, with the natural history of HBV reactivation typically progressing from increased viral replication, to clinically apparent disease activity, and finally to either recovery or progression to fulminant liver failure (Figure 2).[1,7] Risk Factors for HBV Reactivation Persons with chronic HBV infection (HBsAg positive), as well as those with resolved HBV infection (HBsAg negative and anti-HBc positive), are at risk for reactivation of HBV

These fragile neovessels are prone to rupture, leading to vision-threatening complications such as vitreous hemorrhage and tractional retinal detachment

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