QuizWise 32

Q 1 – One or more of the following are true for retinal pigment epithelial tears. 

  1. All patients with Choroidal neovascularization will get a retinal pigment epithelial tear
  2. Retinal pigment epithelial tears are often associated with intravitreal Anti VEGF injections
  3. Retinal pigment epithelial tears  always heal by sliding and proliferation of  the epithelium
  4. One can predict which patient with CNV will  develop a RPE tear. 

Q 2 – RPE tears may occur in one or more of the above. 

  1. Central serous retinopathy
  2. Traumatic chorioretinopathy
  3. Glaucoma surgery
  4. High myopia
  5. Geograpic atrophy
  6. Toxemia of pregnancy

Answers –

Q. 1 Answer –   2.  Retinal pigment epithelial tears have often been associated with anti VEGF injections. 

All patients with CNV do not develop RPE tears. While RPE can slide and perhaps proliferate also,  it would be very unlikely for a RPE tear to heal. It is very hard and perhaps not possible to predict  which patients with CNV will develop a RPE tear. 

Q. 2 answer –  All the above.   

RPE tears have been associated with all The above conditions, however they are found most commonly in patients with CNV where anti VEGF injections have been given.  The accumulation of fluid in the sub RPE neovascular membrane, ( vascularised RPE)  applied hydrostatic pressure to the RPE and stretches it.  Contraction of the neovascular membrane   exerts tractional forces on the RPE, resulting in the tear. In essence the theory is that the RPE can stretch  because of the neovascular membrane associarfte3d growth and fluid accumulation, but when   the membrane contracts following anti VEGF injection,  the RPE  develops a tear. 

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