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Kanishka R. Mendis, Noemi Lois; Healing Of The Retinal Pigment Epithelium (RPE) Imaged ‘In Vivo’ By Fundus Autofluorescence In A Series Of Patients With RPE Tears. Invest. Ophthalmol. Vis. Sci. 2012;53(14):791.
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To describe findings on fundus auto fluorescence (AF) in a group of consecutive patients presenting with retinal pigment epithelial (RPE) tears secondary to age related macular degeneration and to report on functional and anatomical outcomes following the occurrence of the event.
All RPE tears that occurred between 01/03/2008-01/03/2011 were included. AF images were assessed qualitatively and quantitatively. There was an area of reduced AF signal corresponding to the area, debrided of RPE. This area was measured at baseline (B) and last follow-up (L) on 30° AF image frames in all patients with Heidelberg HRA-2 image analysis software. The change in the reduced AF signal area was calculated by subtraction, from baseline the last follow-up, reduced AF signal area. The resultant, reduced, AF signal area was used to determine recovery or progression (image 1). Recovery was defined as a reduction in the area of reduced AF signal and progression was defined as an increase in the area of reduced AF signal.
Fourteen eyes of 13 patients (mean age 82) with RPE tears followed for a median of 11.5 months (range, 1-39) were included in this study. The median Log-MAR VA pre/post RPE tear was 0.5 (6/12) and 0.8 (6/36) respectively. A typical RPE tear on AF imaging had an area of reduced AF signal (black area- debrided of RPE) and increased AF signal (bright area- rolled, torn RPE). There was recovery of AF signal area in 10 eyes (median recovery 1.3; range- 0.03-6.78) and progression of the reduced AF signal area in 4 (median progression 0.7; range- 0.11-5.58).
A characteristic pattern of fundus AF was observed in RPE tears that allowed for non-invasive diagnosis of this condition. Recovery of the AF signal around the RPE tear was noted in majority of the cases. These results may indicate a degree of ‘healing’ of the RPE defect possibly by proliferating and sliding RPE cells.
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