Rip of the retinal pigment epithelium: report of an atypical case.

A 71-year-old man presented with a large disciform scar in the right eye and hard (nodular) as well as soft (granular) drusen scattered throughout the posterior pole of the left eye. A large serous pigment epithelial detachment was evident in the drusen area of the left fundus. Six months later a tear of the retinal pigment epithelium (RPE) occurred in the left eye. It was located exactly along the peripheral border of the drusen area instead of the border of the RPE detachment where it would have been expected. It is considered that reduced adhesion between the RPE and Bruch's membrane as well as the sharp change in tissue cohesiveness at the border of the drusen area and surrounding healthy tissue were relevant in the pathogenesis of this case.