An atypical case of retinal pigment epithelium tear with remodeling and visual preservation
This report describes a patient with polypoidal choroidal vasculopathy (PCV) with fovea-involving retinal pigment epithelium (RPE) tear that showed tissue remodeling with a good visual outcome. Imaging over the patient’s clinical course from 2019 was reviewed. A 74-year-old female presented with lef...
Saved in:
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2024-12-01
|
| Series: | Taiwan Journal of Ophthalmology |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/tjo.TJO-D-24-00051 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841536594348081152 |
|---|---|
| author | Charles Jit Teng Ong Chui Ming Gemmy Cheung |
| author_facet | Charles Jit Teng Ong Chui Ming Gemmy Cheung |
| author_sort | Charles Jit Teng Ong |
| collection | DOAJ |
| description | This report describes a patient with polypoidal choroidal vasculopathy (PCV) with fovea-involving retinal pigment epithelium (RPE) tear that showed tissue remodeling with a good visual outcome. Imaging over the patient’s clinical course from 2019 was reviewed. A 74-year-old female presented with left submacular hemorrhage and a large multi-lobular pigment epithelial detachment. Left eye vision was 6/19 at the presentation. Indocyanine green angiography (ICGA) revealed underlying PCV. One month after initiation of intravitreal aflibercept (IVA, Bayer), she developed fresh subretinal hemorrhage. An RPE tear of 1 disc area in size, centered over the fovea was diagnosed. The torn RPE edge was scrolled up temporal to the fovea on spectral-domain optical coherence tomography (SD-OCT), with hypertransmission into the choroid observed over the area of RPE loss. Left eye vision after the RPE tear was 6/15. Over the next 2 months, the subretinal hemorrhage resolved following further IVA. At month 3, fundus autofluorescence (FAF) demonstrated hypo-autofluorescence while fundus fluorescein angiography (FFA) and ICGA showed a window defect corresponding to the area of RPE tear. On SD-OCT, there was a faint hyper-reflective layer where one might expect the RPE layer to be. Serial SD-OCT scans over 5 years revealed increasing prominence of the hyperreflective layer between the ellipsoid zone and Bruch’s membrane. FAF remained hypo-autofluorescent. At the last review, the patient retained 6/9 vision. We report a case of fovea-involving RPE tear documented with multimodal imaging with good visual outcome, which is atypical. Serial OCT suggests tissue remodeling may explain the functional preservation. |
| format | Article |
| id | doaj-art-c62172e7d48842c18ebb2db5b94dd8f2 |
| institution | Kabale University |
| issn | 2211-5056 2211-5072 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Taiwan Journal of Ophthalmology |
| spelling | doaj-art-c62172e7d48842c18ebb2db5b94dd8f22025-01-14T15:51:54ZengWolters Kluwer Medknow PublicationsTaiwan Journal of Ophthalmology2211-50562211-50722024-12-0114461461810.4103/tjo.TJO-D-24-00051An atypical case of retinal pigment epithelium tear with remodeling and visual preservationCharles Jit Teng OngChui Ming Gemmy CheungThis report describes a patient with polypoidal choroidal vasculopathy (PCV) with fovea-involving retinal pigment epithelium (RPE) tear that showed tissue remodeling with a good visual outcome. Imaging over the patient’s clinical course from 2019 was reviewed. A 74-year-old female presented with left submacular hemorrhage and a large multi-lobular pigment epithelial detachment. Left eye vision was 6/19 at the presentation. Indocyanine green angiography (ICGA) revealed underlying PCV. One month after initiation of intravitreal aflibercept (IVA, Bayer), she developed fresh subretinal hemorrhage. An RPE tear of 1 disc area in size, centered over the fovea was diagnosed. The torn RPE edge was scrolled up temporal to the fovea on spectral-domain optical coherence tomography (SD-OCT), with hypertransmission into the choroid observed over the area of RPE loss. Left eye vision after the RPE tear was 6/15. Over the next 2 months, the subretinal hemorrhage resolved following further IVA. At month 3, fundus autofluorescence (FAF) demonstrated hypo-autofluorescence while fundus fluorescein angiography (FFA) and ICGA showed a window defect corresponding to the area of RPE tear. On SD-OCT, there was a faint hyper-reflective layer where one might expect the RPE layer to be. Serial SD-OCT scans over 5 years revealed increasing prominence of the hyperreflective layer between the ellipsoid zone and Bruch’s membrane. FAF remained hypo-autofluorescent. At the last review, the patient retained 6/9 vision. We report a case of fovea-involving RPE tear documented with multimodal imaging with good visual outcome, which is atypical. Serial OCT suggests tissue remodeling may explain the functional preservation.https://journals.lww.com/10.4103/tjo.TJO-D-24-00051polypoidal choroidal vasculopathyage-related macular degenerationretinal pigment epitheliumretinal pigment epithelium teartissue remodelingmultimodal imaging |
| spellingShingle | Charles Jit Teng Ong Chui Ming Gemmy Cheung An atypical case of retinal pigment epithelium tear with remodeling and visual preservation Taiwan Journal of Ophthalmology polypoidal choroidal vasculopathy age-related macular degeneration retinal pigment epithelium retinal pigment epithelium tear tissue remodeling multimodal imaging |
| title | An atypical case of retinal pigment epithelium tear with remodeling and visual preservation |
| title_full | An atypical case of retinal pigment epithelium tear with remodeling and visual preservation |
| title_fullStr | An atypical case of retinal pigment epithelium tear with remodeling and visual preservation |
| title_full_unstemmed | An atypical case of retinal pigment epithelium tear with remodeling and visual preservation |
| title_short | An atypical case of retinal pigment epithelium tear with remodeling and visual preservation |
| title_sort | atypical case of retinal pigment epithelium tear with remodeling and visual preservation |
| topic | polypoidal choroidal vasculopathy age-related macular degeneration retinal pigment epithelium retinal pigment epithelium tear tissue remodeling multimodal imaging |
| url | https://journals.lww.com/10.4103/tjo.TJO-D-24-00051 |
| work_keys_str_mv | AT charlesjittengong anatypicalcaseofretinalpigmentepitheliumtearwithremodelingandvisualpreservation AT chuiminggemmycheung anatypicalcaseofretinalpigmentepitheliumtearwithremodelingandvisualpreservation AT charlesjittengong atypicalcaseofretinalpigmentepitheliumtearwithremodelingandvisualpreservation AT chuiminggemmycheung atypicalcaseofretinalpigmentepitheliumtearwithremodelingandvisualpreservation |