Rapid progression of proliferative diabetic retinopathy to tractional retinal detachment during chemotherapy: A case report

Tractional retinal detachment is an advanced vision-threatening stage of proliferative diabetic retinopathy. Systemic stressors such as malignancy and chemotherapy may accelerate retinal ischemia and neovascular activity, particularly when ophthalmic treatment adherence is interrupted. A 52-year-old man with a 10-year history of type 2 diabetes mellitus and Stage III diffuse large B-cell lymphoma presented with progressive visual loss after missing intravitreal therapy for five months during chemotherapy. Examination and optical coherence tomography confirmed macula-involving tractional retinal detachment with fibrovascular proliferation and a peripheral retinal break. Pars plana vitrectomy with membrane peeling, endolaser photocoagulation, air tamponade, and intraoperative ranibizumab resulted in retinal reattachment and partial visual recovery. Multiple systemic and treatment-related factors, including treatment interruption, may contribute to the rapid progression of proliferative diabetic retinopathy. Patients undergoing systemic cancer therapy require close ophthalmic monitoring and individualized treatment strategies emphasizing durability.