Retinal pigment epithelium tears: Classification, pathogenesis, predictors, and management

Ersöz, Mehmet Giray; Karaçorlu, Murat; Arf, Serra; Muslubaş, Işıl Sayman; Hocaoğlu, Mümin

doi:10.1016/j.survophthal.2017.03.004

Cited by 67 publications

(86 citation statements)

References 113 publications

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“…A disruption to the external limiting membrane and ellipsoid zone, retinal folds or subretinal fibrin may be frequently detected [ 6 ]. OCT also shows RPE tear as a dense hyperreflectivity zone, corresponding to RPE duplication, next to a less intense hyperreflective area due to the bare choroid [ 20 ] ( Figure 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Near-infrared images disclose irregular, notable hyper-reflectivity at the scrolled edge of the RPE tear, and homogeneous, slight hyper-reflectivity in the denuded zone [ 20 ].…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, slow and rather diffuse bilateral leakage attest diffuse decompensation of the RPE [ 22 ]. In particular, the crescent RPE tear appears as a window defect (the bare choroid) next to an hypofluorescence (the rolled RPE layer), in all angiographic phases if it has a crescent shape type [ 20 ]. Conversely, concentric RPE tear appears as an island of retracted RPE tissue at the center of the tear, with a hyperfluorescent area all around [ 6 ].…”

Section: Resultsmentioning

confidence: 99%

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Bullous Central Serous Chorioretinopathy: A Rare and Atypical Form of Central Serous Chorioretinopathy. A Systematic Review

et al. 2020

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Bullous central serous chorioretinopathy (bCSCR) is a rare variant of the central serous chorioretinopathy, complicated by an exudative retinal detachment with shifting fluid. This systematic review aims to present the epidemiology, the pathogenesis, the clinical presentation, the imaging, the differential diagnosis, and the latest treatments of this disease. A total of 60 studies were identified following a literature search adhering to PRISMA guidelines. After full-text evaluation, 34 studies about bCSCR were included. bCSCR usually affects middle-aged men, and the principal risk factor is corticosteroid medications. Pathogenesis is related to an increased choroidal vessel and choriocapillaris permeability, with subsequent subretinal fluid accumulation, rich in fibrin, which may provoke the exudative retinal detachment. Clinical presentation and imaging are fundamental to distinguish bCSCR from other pathologies, avoiding unappropriated treatment. Corticosteroid withdraws (if assumed) and laser photocoagulation of leakage sites seen at angiography may speed up retinal reattachment. Verteporfin photodynamic therapy, transpupillary thermal therapy, oral eplerenone and scleral thinning surgery are other therapeutic options. An early diagnosis might prevent disease progression due to harmful medications as well as unnecessary surgery.

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Section: Resultsmentioning

confidence: 99%

“…Near-infrared images disclose irregular, notable hyper-reflectivity at the scrolled edge of the RPE tear, and homogeneous, slight hyper-reflectivity in the denuded zone [ 20 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Bullous Central Serous Chorioretinopathy: A Rare and Atypical Form of Central Serous Chorioretinopathy. A Systematic Review

et al. 2020

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“…RPE tears outside the macula, as in this case, are very rare. 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 In particular, there have been only a few reports of RPE tears after glaucoma filtering surgery, 2 , 3 , 4 the pathophysiology has not been clearly described and the appropriate treatment has not been established. In this report, we showed that hypotony is central to the development of this condition and that elevating IOP is essential for the treatment.…”

Section: Discussionmentioning

confidence: 99%

“… 1 Various etiologies cause RPE tears. 2 The most common cause is vascularized RPE detachment in patients with exudative age-related macular degeneration. 1 Other etiologies include central serous chorioretinopathy, 3 angioid streak, 4 high myopia, 5 uveitis, 6 proliferative vitreoretinopathy, 7 and complications of scleral buckling 8 or glaucoma surgery.…”

Section: Introductionmentioning

confidence: 99%

Retinal detachment with retinal pigment epithelial tear under hypotony after trabeculectomy: A case report

Harada

Okumichi

Miyata

et al. 2020

American Journal of Ophthalmology Case Reports

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Purpose To report a case of retinal detachment with retinal pigment epithelium (RPE) tear, under hypotony after trabeculectomy, which immediately resolved upon elevation of intraocular pressure. Observations A 67-year-old man who had undergone trabeculectomy presented for treatment of a visual field defect in his left eye. His glaucoma surgery was uneventful. At his first visit to our clinic, the patient's visual acuity was 15/20 in the right eye and 20/40 in the left; intraocular pressure was 18 mmHg in the right and 5 mmHg in the left. Fundus examination of the left eye revealed a retinal detachment, overlying a choroidal detachment, and an RPE tear. The retinal detachment did not resolve with systemic steroid pulse therapy or vitrectomy. The patient was then diagnosed with an exudative retinal detachment with RPE tear under hypotony, and transconjunctival sutures were applied to tighten the scleral flap, to elevate intraocular pressure. After the transconjunctival sutures were applied, intraocular pressure increased to 10 mmHg and the exudative retinal detachment immediately resolved. There was no recurrence of retinal detachment after the intervention. Conclusions and importance Because there have been few case reports of retinal detachment with an RPE tear after glaucoma filtering surgery, no therapeutic strategy has yet been proposed. The findings in this case indicate that intraocular pressure elevation is effective for treating exudative retinal detachment with RPE tear in cases of hypotony after glaucoma filtering surgery.

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Modulated release from implantable ocular silicone oil tamponade drug reservoirs

Cauldbeck

Hellaye

McDonald

et al. 2018

J. Polym. Sci. Part A: Polym. Chem.

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Complicated cases of retinal detachment can be treated with silicone oil tamponades. There is the potential for silicone oil tamponades to have adjunctive drug releasing behaviour within the eye, however the lipophilic nature of silicone oil limits the number of drugs that are suitable, and drug release from the hydrophobic reservoir is uncontrolled. Here, a radiometric technique was developed to accurately measure drug solubility in silicone oil and measure release into culture media. All‐trans retinoic acid (atRA), a lipophilic drug known to act as an anti‐proliferative within the eye, was used throughout this work. Chain‐end modification of polydimethylsiloxane with atRA produced a polydimethylsiloxane retinoate (PDMS‐atRA), which was used as an additive to silicone oil to modify the solvent environment within the silicone oil and the distribution coefficient. Blends of PDMS‐atRA and silicone oil containing different concentrations of free atRA were produced. The presence of PDMS‐atRA in silicone oil had a positive effect on atRA solubility and the longevity of release in vitro. The drug release period was independent of atRA starting concentration and dependent on the PDMS‐atRA concentration in the blend. A clinically relevant release period of atRA over 7 weeks from a silicone oil blend with PDMS‐atRA was observed. © 2018 The Authors. Journal of Polymer Science Part A: Polymer Chemistry Published by Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2018, 56, 938–946

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Retinal pigment epithelium tears: Classification, pathogenesis, predictors, and management

Cited by 67 publications

References 113 publications

Bullous Central Serous Chorioretinopathy: A Rare and Atypical Form of Central Serous Chorioretinopathy. A Systematic Review

Bullous Central Serous Chorioretinopathy: A Rare and Atypical Form of Central Serous Chorioretinopathy. A Systematic Review

Retinal detachment with retinal pigment epithelial tear under hypotony after trabeculectomy: A case report

Modulated release from implantable ocular silicone oil tamponade drug reservoirs

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