Age Related Macular Degeneration

RPE tears occur in AMD as part of the normal disease progression. They are usually associated with vascularized pigment epithelial detachments at a rate of 10%. RPE tears are also associated with Central Serous Retinopathy, Retinal Angiomatous Proliferation, Polypoidal Choroidal Vasculopathy, Angioid Streaks, trauma, and various treatment modalities.

We present a 67-year-old man with poor vision for many years. Vision is 20/25 in the right eye and 20/200 in the left eye. He is diagnosed with non-exudative AMD. His right eye is observed over 17 months, when he develops a spontaneous RPE tear. SS- OCTA rules out type 1 macular neovascularization in the right eye. Two months prior to the RPE tear, the patient had undergone uncomplicated cataract surgery in the right eye. The question arises whether cataract surgery is associated with RPE tears. Given that there were no signs of type 1 macular neovascularization, the patient is observed closely. The presence of RPE tears allows us to directly visualize the choriocapillaris and perform a naturally occurring experiment to further understand the relationship between the RPE and the choriocapillaris. 

Presentation Date: 01/09/2020

Issue Date: 08/01/2020