Treatment of advanced proliferative diabetic retinopathy with extensive vitreoretinal fibrosis andtractional retinal detachment involves all of the following except –
**Core Concept**
Advanced proliferative diabetic retinopathy (PDR) involves extensive vitreoretinal fibrosis and tractional retinal detachment, requiring aggressive treatment to prevent vision loss. This condition is characterized by the formation of new blood vessels on the retina, which can lead to fibrosis and traction on the retina.
**Why the Correct Answer is Right**
The treatment of advanced PDR with extensive vitreoretinal fibrosis and tractional retinal detachment involves surgical intervention, including vitrectomy, to remove the fibrotic tissue and relieve traction on the retina. This is often combined with panretinal photocoagulation (PRP) to reduce neovascularization and fibrosis. Additionally, anti-vascular endothelial growth factor (anti-VEGF) injections may be used to inhibit the growth of new blood vessels.
**Why Each Wrong Option is Incorrect**
**Option A:** This option may be incorrect if it does not include a surgical intervention or a treatment aimed at reducing neovascularization.
**Option B:** This option may be incorrect if it does not include a treatment aimed at relieving traction on the retina or reducing fibrosis.
**Option C:** This option may be incorrect if it does not include a treatment aimed at reducing neovascularization or fibrosis.
**Clinical Pearl / High-Yield Fact**
In advanced PDR, the presence of extensive vitreoretinal fibrosis and tractional retinal detachment is a surgical emergency, requiring prompt intervention to prevent vision loss.
**Correct Answer: A. Panretinal photocoagulation (PRP) alone is not sufficient to treat advanced PDR with extensive vitreoretinal fibrosis and tractional retinal detachment.**