Giant Retinal Pigment Epithelium Tear Resulting in Neurosensory Retinal Detachment: An Atypical Case. (November 2022)

• Record Type: Journal Article
• Authors: Rana, Harkaran S.; Cox, Anthony R.; Biles, Evan C.; Broderick, Kevin
• Is Part Of: Journal of vitreoretinal diseases. Volume 6:Number 6(2022)
• Page Start: 461
• Page End: 466
• Publication Date: 2022-11
• Subjects: Neurosensory retinal detachment -- pigment epithelial detachment -- retinal pigment epithelial tear; Retina -- Diseases -- Periodicals; Vitreous body -- Diseases -- Periodicals; Retina -- Diseases; Vitreous body -- Diseases; Periodicals; 617.735005
• DOI: 10.1177/24741264211062928
• Languages: English
• ISSNs: 2474-1264

Abstract

Purpose: We report a rare case of neurosensory retinal detachment (RD) in the setting of a giant retinal pigment epithelium (RPE) tear. Methods: A 58-year-old man presented with a macula-involving RD in the left eye. Exam revealed a neurosensory detachment inferiorly and RPE abnormalities temporally. Optical coherence tomography showed a large RPE tear and detachment in the temporal macula contiguous with a neurosensory RD. Results: No clear etiology was identified and failure of conservative management led to vitrectomy with RD repair. Follow-up intravenous fluorescein angiography 3 months postoperatively showed a large RPE window defect. Conclusions: RPE tears are common; however, concomitant neurosensory RD is rare. A thorough workup to determine treatable causative factors is necessary; in the event of idiopathic diagnosis, close follow-up is necessary to determine the need for surgery. Pars plana vitrectomy, external drainage of subretinal fluid, endolaser, and 5000-centistoke silicone oil placement were successful in this patient.