An improvement in visual acuity accompanied by the development of RPE tear: a case report

Abstract Background Retinal pigment epithelium (RPE) tear is a well-known complication of RPE detachment and is typically associated with significant visual acuity decline. However, in this case, despite the occurrence of an RPE tear there was an unexpected improvement in visual acuity. Case present...

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Main Authors: Xinyu Liu, Shulin Liu, Zhiyan Xu, Youxin Chen
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Ophthalmology
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Online Access:https://doi.org/10.1186/s12886-025-03848-9
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author Xinyu Liu
Shulin Liu
Zhiyan Xu
Youxin Chen
author_facet Xinyu Liu
Shulin Liu
Zhiyan Xu
Youxin Chen
author_sort Xinyu Liu
collection DOAJ
description Abstract Background Retinal pigment epithelium (RPE) tear is a well-known complication of RPE detachment and is typically associated with significant visual acuity decline. However, in this case, despite the occurrence of an RPE tear there was an unexpected improvement in visual acuity. Case presentation A 68-year-old male presented with blurred vision in his right eye of a month’s duration. Pachychoroid neovasculopathy was diagnosed. After monthly anti-vascular endothelial growth factor injections over a three months period. the choroidal neovascular membrane gradually diminished. While the pigment epithelial detachment expanded and the subretinal fluid increased. This was accompanied by deterioration in the visual acuity of the patient. The anti-VEGF treatment was discontinued, expectant management was adopted. Three months later, a retinal pigment epithelium tear was observed near the fovea, unexpectedly accompanied by complete resolution of the subretinal fluid, partial reattachment of the RPE detachment, and a significant improvement in visual acuity. Conclusions This case presents a rare instance of significant improvement in visual acuity and anatomical reconstruction of macular structure following the development of a retinal pigment epithelial (RPE) tear in a patient with pachychoroid neovasculopathy. We suggest that the fovea-sparing nature of the RPE tear in our case and the resulting “incision and drainage” effect may explain this unexpected outcome.
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spelling doaj-art-bfd3d936d71d4ccf8949fbe6b8c1c9372025-01-12T12:12:24ZengBMCBMC Ophthalmology1471-24152025-01-012511610.1186/s12886-025-03848-9An improvement in visual acuity accompanied by the development of RPE tear: a case reportXinyu Liu0Shulin Liu1Zhiyan Xu2Youxin Chen3Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeChongqing Key Laboratory of Ophthalmology, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye InstituteDepartment of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeAbstract Background Retinal pigment epithelium (RPE) tear is a well-known complication of RPE detachment and is typically associated with significant visual acuity decline. However, in this case, despite the occurrence of an RPE tear there was an unexpected improvement in visual acuity. Case presentation A 68-year-old male presented with blurred vision in his right eye of a month’s duration. Pachychoroid neovasculopathy was diagnosed. After monthly anti-vascular endothelial growth factor injections over a three months period. the choroidal neovascular membrane gradually diminished. While the pigment epithelial detachment expanded and the subretinal fluid increased. This was accompanied by deterioration in the visual acuity of the patient. The anti-VEGF treatment was discontinued, expectant management was adopted. Three months later, a retinal pigment epithelium tear was observed near the fovea, unexpectedly accompanied by complete resolution of the subretinal fluid, partial reattachment of the RPE detachment, and a significant improvement in visual acuity. Conclusions This case presents a rare instance of significant improvement in visual acuity and anatomical reconstruction of macular structure following the development of a retinal pigment epithelial (RPE) tear in a patient with pachychoroid neovasculopathy. We suggest that the fovea-sparing nature of the RPE tear in our case and the resulting “incision and drainage” effect may explain this unexpected outcome.https://doi.org/10.1186/s12886-025-03848-9Retinal pigment epithelium tearRetinal pigment epithelial detachmentPachychoroid neovasculopathy
spellingShingle Xinyu Liu
Shulin Liu
Zhiyan Xu
Youxin Chen
An improvement in visual acuity accompanied by the development of RPE tear: a case report
BMC Ophthalmology
Retinal pigment epithelium tear
Retinal pigment epithelial detachment
Pachychoroid neovasculopathy
title An improvement in visual acuity accompanied by the development of RPE tear: a case report
title_full An improvement in visual acuity accompanied by the development of RPE tear: a case report
title_fullStr An improvement in visual acuity accompanied by the development of RPE tear: a case report
title_full_unstemmed An improvement in visual acuity accompanied by the development of RPE tear: a case report
title_short An improvement in visual acuity accompanied by the development of RPE tear: a case report
title_sort improvement in visual acuity accompanied by the development of rpe tear a case report
topic Retinal pigment epithelium tear
Retinal pigment epithelial detachment
Pachychoroid neovasculopathy
url https://doi.org/10.1186/s12886-025-03848-9
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