Retinal Pigment Epithelium Tears: Risk Factors, Mechanism and Therapeutic Monitoring

Ophthalmologica. 2016;235(1):1-9. doi: 10.1159/000439445. Epub 2015 Oct 22.

Abstract

Tears of the retinal pigment epithelium (RPE) are most commonly associated with vascularised RPE detachment due to age-related macular degeneration (AMD), and they usually involve a deleterious loss in visual acuity. Recent studies suggest an increase in RPE tear incidences since the introduction of anti-vascular endothelial growth factor (anti-VEGF) therapies as well as a temporal association between the tear event and the intravitreal injection. As the number of AMD patients and the number of administered anti-VEGF injections increase, both the challenge of RPE tear prevention and the treatment after RPE tear formation have become more important. At the same time, the evolution of retinal imaging has significantly contributed to a better understanding of RPE tear development in recent years. This review summarises the current knowledge on RPE tear development, predictive factors, and treatment strategies before and after RPE tear formation.

Publication types

  • Review

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Drug Monitoring
  • Humans
  • Macular Degeneration / complications
  • Macular Degeneration / drug therapy
  • Macular Degeneration / physiopathology
  • Retinal Detachment / drug therapy
  • Retinal Detachment / etiology
  • Retinal Detachment / physiopathology
  • Retinal Perforations* / drug therapy
  • Retinal Perforations* / etiology
  • Retinal Perforations* / physiopathology
  • Retinal Pigment Epithelium / pathology*
  • Risk Factors
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors

Substances

  • Angiogenesis Inhibitors
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A