PMC6343237_01
Multimodal retinal imaging of a spontaneous retinal pigment epithelium (RPE) tear in the right eye. a Color fundus photograph shows swelling and retinal haemorrhage at the macula and folding of the RPE superior to the fovea (arrow). b Fundus autofluorescence (AF) shows a hyper AF line in correspondence of the folded RPE (arrow). c, d Fluorescein angiography and indocyanine green angiography show presence of a predominanlty classic choroidal neovascularization (CNV). e Subfoveal optical coherence tomography (OCT) scan shows well defined subreitnal hyperreflective material and subretinal fluid. f OCT scan superior to the fovea shows interruption of the RPE (arrowhead)
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PMC6343237_01_40942_2019_155_Fig1_HTML.jpg
Fig1
Multimodal retinal imaging of the RE showed a type 2 (predominantly classic) CNV complicated by a spontaneous retinal pigment epithelial (RPE) tear (Fig. 1).
Optical coherence tomography (OCT) scan showing retinal pigment epithelium (RPE) repair process in the right eye during anti-VEGF treatment. 1 month after treatment: a subfoveal OCT scan shows splitting of the RPE (yellow arrow) with persistent well defined subretinal hyperreflective material (yellow star) and subretinal fluid; b OCT scan superior to the fovea shows continuity of the hyperreflective line attributable to the RPE (white arrow) and envelopment of the hyperreflective material (white star). 9 months after initiation of treatment; c Subfoveal OCT scan shows further consolidation of the hyperreflective material with persistent splitting of the RPE (yellow arrow); d OCT scan superior to the fovea shows reducing subretinal fluid and integrity of the RPE (white arrow)
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PMC6343237_01_40942_2019_155_Fig2_HTML.jpg
Fig2
A course of 3 monthly intravitreal injections of Ranibizumab (0.5 mg x 0.05 mL) was administered. 4 weeks after the third injection OCT scan showed splitting and restoration of the hyperreflective line attributable to the RPE (Fig. 2). 9 months after initiation of treatment patient had received six intravitreal injections of Ranibizumab and BCVA improved to 20/32 in the RE.