Microrips of the retinal pigment epithelium in polypoidal choroidal vasculopathy
Kunihiro Musashi1, Akitaka Tsujikawa, Yasuhiko Hirami
1Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Purpose:
To study the clinical characteristics of microrips of the retinal pigment epithelium (RPE) in polypoidal choroidal vasculopathy (PCV).
Design:
Retrospective case series.
Methods:
For this study, we retrospectively reviewed 156 consecutive eyes of 136 patients with PCV. The lesions were examined with fluorescein angiography and indocyanine green angiography.
Results:
Of 156 eyes with PCV, 11 (7.1%) had microrips of the RPE at the margin of the pigment epithelial detachment. In the early phase of fluorescein angiography, the microrips showed pinpoint leakage from the RPE, which increased and pooled within the subretinal space in the late phase. Of the 11 eyes with microrips, the rip disappeared in 10 eyes (90.9%), and no eyes developed RPE tears during follow-up. The mean duration from the first detection of a microrip to resolution was 3.0 +/- 1.6 months.
Conclusions:
In eyes with PCV, microrips of the RPE are not uncommon, but have minimal clinical relevance.
Insights
Microrips of the retinal pigment epithelium (RPE) in polypoidal choroidal vasculopathy (PCV) are uncommon but typically resolve without complications. These RPE microrips show leakage on angiography but rarely lead to RPE tears.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Choroidal Neovascularization
Background:
- Polypoidal choroidal vasculopathy (PCV) is a common cause of wet age-related macular degeneration.
- Retinal pigment epithelium (RPE) abnormalities are characteristic of PCV.
- Microrips of the RPE have not been extensively studied in the context of PCV.
Purpose of the Study:
- To investigate the clinical features of RPE microrips in patients with PCV.
- To understand the natural history and implications of RPE microrips in PCV.
Main Methods:
- Retrospective case series analysis of 156 eyes from 136 PCV patients.
- Utilized fluorescein angiography and indocyanine green angiography to examine RPE lesions.
- Monitored microrips for resolution and development of RPE tears during follow-up.
Main Results:
- RPE microrips were identified in 7.1% of PCV eyes (11 out of 156).
- Microrips exhibited pinpoint leakage in early fluorescein angiography, pooling in the subretinal space later.
- Resolution of microrips occurred in 90.9% of cases within an average of 3.0 months, with no RPE tears observed.
Conclusions:
- RPE microrips are an infrequent finding in PCV.
- These microrips generally have minimal clinical significance and a favorable prognosis.
- RPE microrips in PCV typically resolve spontaneously without progression to RPE tears.
