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Retinal pigment epithelial tears associated with trauma
L A Levin1, J M Seddon, T Topping
1Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston 02114.
American Journal of Ophthalmology
|October 15, 1991
Summary
Blunt eye or head trauma can cause retinal pigment epithelial tears. This unusual finding suggests acute tangential tractional forces on the macula during globe deformation.
Area of Science:
- Ophthalmology
- Retinal Imaging
- Trauma Research
Background:
- Retinal pigment epithelial (RPE) tears are uncommon ocular injuries.
- Understanding the mechanisms of RPE tears is crucial for patient outcomes.
Observation:
- Two previously healthy male patients experienced RPE tears after significant trauma (blunt eye injury and motorcycle accident).
- Parafoveal RPE tears were noted in both cases following trauma.
Findings:
- Fluorescein angiography revealed mottled window defects corresponding to the tears.
- Blocked fluorescence was observed in areas of rolled-up RPE, without evidence of detachment.
- The observed RPE tears were not associated with pigment epithelial detachments.
Implications:
- The findings suggest a novel mechanism for RPE tears.
- Acute tangential tractional forces during rapid globe deformation are hypothesized as the cause.
- This mechanism may explain unusual RPE tear presentations post-trauma.