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Retinal pigment epithelium tear

Figure 1. Color retinography showing the RPE tear and a fold. The choroid is shown denuded in the area of the tear.

Figure 2. RPE band interruption. Hyperreflectivity in the area of the denuded choroid due to the greater penetration of the beam in the absence of the RPE shield.

Description

Retinal pigment epithelium (RPE) tear is a serious and rare complication of exudative age-related macular degeneration (AMD), which can occur spontaneously or after treatment with intravitreal therapy. It is usually associated with vascularized detachments of the RPE, and often involves a severe loss of visual acuity. The increase in the prevalence of AMD, as well as intravitreal treatments, are leading to a progressive increase in the incidence of this pathology.

Comments

Indication

A 78-year-old woman presented with central visual loss in her left eye, with a corrected visual acuity of 0.4 (decimal scale, Snellen). Biomicroscopic examination revealed macular thickening without retinal hemorrhages and RPE detachment with intraretinal fluid on Optical Coherence Tomography (OCT). She was scheduled for a triple loading dose of antiangiogenic therapy and, after the second injection, the patient consulted again due to sudden visual loss a few days after the procedure, with a visual acuity of 0.05 and the presence of a RPE tear on examination.