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LONG-TERM FOLLOW-UP OF RETINAL PIGMENT EPITHELIUM RESTORATION AFTER A TRIPLE TEAR

Zahid, Sarwar, MD*; Dolz Marco, Rosa, MD, PhD†,‡; Freund, K. Bailey, MD*,†,‡,§

Retinal Cases and Brief Reports: January 2019 - Volume 13 - Issue 1 - p 5–9
doi: 10.1097/ICB.0000000000000530
Case Report
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Purpose: To demonstrate longitudinal multimodal imaging findings in a case of neovascular age-related macular degeneration presenting with multiple retinal pigment epithelium (RPE) tears showing progressive RPE restoration.

Methods: Observational clinical case report.

Results: A 79-year-old woman diagnosed with neovascular age-related macular degeneration developed 3 consecutive RPE tears in her right eye during the course of treatment with intravitreal anti–vascular endothelial growth factor therapy. The RPE tears initially appeared hypoautofluorescent on fundus autofluorescence. Spectral domain optical coherence tomography showed contractile folds of the RPE with adjacent subretinal fluid and overlying ellipsoid zone disruption. Over an 8-year follow-up period, the RPE defects progressively resolved with a return of patchy fundus autofluorescence. Eye-tracked spectral domain optical coherence tomography showed gradual restoration of the RPE band defects over an enlarging Type 1 neovascular lesion.

Conclusion: Some RPE tears may show observable remodeling and restoration over time. These changes may be followed longitudinally with multimodal imaging, including eye-tracked spectral domain optical coherence tomography and fundus autofluorescence.

Using a multimodal imaging approach, the authors show retinal pigment epithelium restoration after a triple retinal pigment epithelium tear in an eye with neovascular age-related macular degeneration receiving continuous intravitreal anti–vascular endothelial growth factor therapy over an 8-year follow-up.

*Department of Ophthalmology, New York University Langone Medical Center, New York, New York;

Vitreous Retina Macula Consultants of New York, New York, New York;

LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, New York; and

§Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York.

Reprint requests: K. Bailey Freund, MD, Vitreous Retina Macula Consultants of New York, 460 Park Avenue, 5th Floor, New York, NY 10022; e-mail: kbfnyf@aol.com

Supported by The Macula Foundation, Inc.

K. B. Freund: Consultant to Optovue (Fremont, CA), Genentech (South San Francisco, CA), Optos (Marlborough, MA), Bayer HealthCare (Müllerstr, Berlin), and Heidelberg Engineering (Franklin, MA) (honorarium for each). R. Dolz Marco: Research grants from Alcon, Bayer, Heidelberg Engineering, Novartis, Roche, and Thea. The remaining author has no financial/conflicting interests to disclose.

© 2019 by Ophthalmic Communications Society, Inc.