Clinical features of cases with retinal pigment epithelium aperture

Abstract

Purpose To report the clinical findings of the patients with retinal pigment epithelium (RPE) aperture secondary to age-related macular degeneration (AMD). Methods A retrospective data analysis was conducted of patients at the University of Tokyo Hospital eye clinic, from the year September 1st, 2012 to 2019. Review of the medical records of patients with RPE aperture accompanied by AMD was performed. We investigated age, best-corrected visual acuity (BCVA), images of spectral domain optical coherence tomography, short-wave fundus autofluorescence (FAF), fluorescein angiography (FA), indocyanine green angiography, and retinal sensitivity measured with microperimetry. The change in visual acuity or the area of the aperture during the follow-up period was analyzed. Results Five eyes of 5 patients (4 men, one woman) were included in the analysis. The mean age at presentation was 78.6 ± 9.1 years. The average length of follow-up was 23.6 ± 17.9 months. The RPE apertures appeared as round, either at the apex or at the base of PED, with no evidence of accompanying CNV but subretinal detachment (SRD) above the aperture. On FAF, the apertures appeared as sharply demarcated round areas of hypoautofluorescence. The FA revealed sharply demarcated round areas of window defects in the early and mid-phase with leakage in the late phase corresponding to SRD. The area of apertures enlarged during the follow-up period. Mean BCVA got worse from 0.20 logMAR at the initial presentation to 0.39 logMAR at the last visit. The retinal sensitivity was reduced but partly preserved above the area of aperture. Conclusions and importance RPE aperture was found in some patients with drusenoid PED secondary to AMD. It enlarged during follow-up. Visual acuity was declined. Retinal sensitivity was decreased but partly preserved.

Clinical and multimodal imaging findings in a case of serous maculopathy with absence of retinal pigment epithelium (SMARPE)

“…The absence of RPE detachments and the morphology of the surrounding RPE, evidence of folds, or areas of traction can differentiate this entity from RPE apertures and tears that usually occur in relatively large dome-shaped RPE detachments. 1,3,4 The lack of leakage on FA helps differentiate SMARPE from other entities that present CNV.…”

Retinal pigment epithelium apertures associated with subretinal fluid and acquired vitellifom lesions in non-neovascular age-related macular degeneration

“…Querques et al 2 studied 10 eyes, most with drusenoid pigment epithelial detachment (PED) that developed such RPE defects. Similarly, Giannakaki-Zimmermann et al 3 reported 7 eyes with apertures, of which 4 displayed drusenoid PED, whereas Yoshinaga et al 4 studied 5 cases of RPE defect all associated with drusenoid PED.…”