RECURRENT RPE MICRORIPS IN A CASE OF VASCULARIZED PIGMENT EPITHELIAL DETACHMENT

Microrips of the RPE are an infrequent finding in vascularised pigment epithelial detachments (PEDs). Fluorescein angiography revealed that they are identical to the leaks seen in central serous chorioretinopat hy (CSC); it has been hypothesised that both may be caused by hydrosta tic forces generating a mechanical disruption of the RPE. We report a case of vascularised FED that was complicated by repeated subretinal h aemorrhages and presented recurrent microrips of the RPE, which is a f inding never described before according to our knowledge. In this case , a very high protein concentration in the subretinal space, due to pr olonged bleeding from the neovascular membrane, might have damaged the RPE and reduced the choroidal suction, as believed for CSC. It might also have increased the intraluminal pressure in the FED, finally dete rmining the passage of fluid through the microrips, which have been hy pothesised to be RPE defects. These observations represent further spe culation about the pathogenesis and the unique angiographic pattern of the leaks in CSC and of RPE microrips.