Cavallero E, Corvi F, Souied E, Bandello F, Querques G
Department of ophthalmology, IRRCS Ospedale San Raffaele, Vita-Salute University, 20132 Milan, Italy; Department of ophthalmology, university Paris Est Créteil, centre hospitalier intercommunal de Créteil, 94010 Créteil, France.
Department of ophthalmology, IRRCS Ospedale San Raffaele, Vita-Salute University, 20132 Milan, Italy.
J Fr Ophtalmol. 2016 Jan;39(1):64-8. doi: 10.1016/j.jfo.2015.05.010. Epub 2015 Dec 8.
To report two cases of spontaneous retinal pigment epithelial (RPE) tears occurring in two patients affected with geographic atrophy (GA) due to non-exudative age-related macular degeneration (AMD).
Two patients (a 79-year-old man and a 71-year-old woman) presented to our department with progressive visual loss. The man had a best-corrected visual acuity (BCVA) of 20/100 in the right eye (RE) and 20/50 in the left eye (LE); the woman had a BCVA of 20/200 in the RE and 20/160 in the LE. Upon complete ophthalmologic examination, revealing a large area of atrophy (>175 μm in diameter) along with pigmentary changes, calcified drusen and no choroidal neovascularization (CNV) in either eye, the patients were diagnosed with GA due to non-exudative AMD. Interestingly, the imaging modalities performed, including fluorescein angiography (FA), indocyanine green angiography (ICGA) and spectral-domain optical coherence tomography (SD-OCT), clearly highlighted the presence of spontaneous RPE tears in the context of non-exudative AMD, while in general, RPE tears are a well-recognized complication of exudative AMD.
To our knowledge, this is the first description of spontaneous RPE tears as a possible complication of GA due to non-exudative AMD.
报告两例因非渗出性年龄相关性黄斑变性（AMD）导致地图样萎缩（GA）的患者发生自发性视网膜色素上皮（RPE）撕裂的病例。
两名患者（一名79岁男性和一名71岁女性）因视力进行性下降前来我科就诊。该男性右眼最佳矫正视力（BCVA）为20/100，左眼为20/50；该女性右眼BCVA为20/200，左眼为20/160。经过全面的眼科检查，发现两只眼睛均有大面积萎缩（直径>175μm），伴有色素改变、钙化性玻璃膜疣，且无脉络膜新生血管（CNV），这两名患者被诊断为非渗出性AMD所致的GA。有趣的是，所进行的成像检查，包括荧光素血管造影（FA）、吲哚菁绿血管造影（ICGA）和光谱域光学相干断层扫描（SD-OCT），清楚地显示了在非渗出性AMD背景下存在自发性RPE撕裂，而一般来说，RPE撕裂是渗出性AMD一种公认的并发症。
据我们所知，这是首次将自发性RPE撕裂描述为非渗出性AMD所致GA的一种可能并发症。
