GIANT RETINAL-PIGMENT EPITHELIAL TEARS IN ACUTE RETINAL NECROSIS

We observed large peripheral tears of the retinal pigment epithelium i n two patients, a 59-year-old man and a 15-year-old girl, who had acut e retinal necrosis. These tears ranged from 90 to 180 degrees of the c ircumference of the peripheral retinal pigment epithelium and occurred in areas of previous retinal viral infection. Both patients had curle d folds of tissue at the posterior edge of the retinal pigment epithel ial tear. During vitrectomy at the time of fluid-air exchange, we note d the edge of these tears to sag posteriorly. Because of the area that was denuded of retinal pigment epithelium by the tears, we selected a more posterior location for argon laser endo-photocoagulation in both patients. These large retinal pigment epithelial tears did not appear to have an adverse effect on the outcome of surgical treatment of the retinal detachments.