Retinal pigment epithelial tears through the fovea with preservation of good visual acuity
N. M. Bressler, D. Finklestein, J. S. Sunness, A. M. Maguire and D. Yarian
Wilmer Ophthalmological Institute, Johns Hopkins Hospital, Baltimore, Md 21205.
We describe two patients with spontaneous retinal pigment epithelial tears
through the fovea who have maintained at least 20/40 visual acuity for 1
year and 3 years following the rip. Both patients had long-standing serous
detachments of the retinal pigment epithelium associated with age-related
macular degeneration prior to the development of the tear. Each tear was at
least five disc areas in size and centered on the fovea. Foveal fixation
was documented despite the presumed absence of pigment epithelium. This
observation suggests either that there may be remaining or redundant
pigment epithelium or that pigment epithelium directly beneath the central
macula is not required for maintenance of 20/40 visual acuity.
