A torn retina in hypertensive chorioretinopathy is associated with which prognosis?

• A. Good
• B. Grave
• C. Guarded
• D. Unknown

Answer: (B)

A torn retina in the setting of hypertensive chorioretinopathy signals a very serious ocular situation from a dangerous systemic condition. Hypertensive chorioretinopathy reflects acute, severe hypertension causing microvascular damage in the retina. When a retinal tear occurs, it can lead to rhegmatogenous retinal detachment, a condition that threatens central vision and often requires urgent surgical repair. The combination indicates advanced, aggressive disease with high risk of permanent vision loss, so the prognosis for vision is grave. Prompt systemic blood pressure control and retinal detachment management are essential, but even with treatment the outcome for vision is often poor if the detachment has involved the macula or there has been prolonged ischemia.