A 50-year-old diabetic woman has a macula-off tractional retinal detachment of 5 days duration. She undergoes successful vitrectomy and retinal reattachment. What is the MOST realistic prognosis for visual recovery?
- A Full recovery to 6/6 within 1 month
- B Recovery to 6/60 or better in most cases but full recovery is unlikely given chronic photoreceptor damage ✓
- C No visual improvement expected
- D Recovery to 6/18 is expected within 1 week
Correct answer: B. Recovery to 6/60 or better in most cases but full recovery is unlikely given chronic photoreceptor damage
Explanation
After macula-off tractional RD of even short duration in diabetics, visual prognosis is guarded. Many patients achieve ambulatory or reading vision (6/60–6/18 range) after successful reattachment, but the combination of pre-existing diabetic maculopathy, photoreceptor outer segment disorganisation, and RPE dysfunction limits recovery. Full 6/6 recovery is exceptional. Longer duration of macular detachment predicts worse visual outcome.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
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