title: Thinning and small holes at an impending tear of a retinal pigment epithelial detachment.
abstract: BACKGROUND
  A tear of a retinal pigment epithelial detachment (PED) suddenly exposes a large area of bare Bruch's membrane. We report here the case of a patient whom we observed during the gradual, spontaneous development of a PED tear.
  
  
  METHODS
  A 5.25-year case study of a 67-year-old woman with bilateral serous PEDs.
  
  
  RESULTS
  Retinal pigment epithelial (RPE) thinning or small holes were seen along the PED margin in both eyes. Fluorescein angiograms showed intense hyperfluorescence without leakage, and indocyanine green angiography showed choroidal vessels through regions of RPE thinning or small holes. Optical coherence tomographs showed an interruption of a hyperreflective band corresponding to retinal pigment epithelium. A typical tear of the PED ensued later.
  
  
  CONCLUSIONS
  Multiple, small regions of RPE thinning or holes along the margin of PED can be a sign of an impending PED tear.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Osaka City University Graduate School of Medicine, Osaka, Japan. shiraki@med.osaka-cu.ac.jp
authors.forename: K
authors.initials: K
authors.lastname: Shiraki
authors.forename: T
authors.initials: T
authors.lastname: Kohno
authors.forename: S
authors.initials: S
authors.lastname: Ataka
authors.forename: K
authors.initials: K
authors.lastname: Abe
authors.forename: K
authors.initials: K
authors.lastname: Inoue
authors.forename: T
authors.initials: T
authors.lastname: Miki
mesh_terms: D000368:Aged; D002829:Choroid / Q000098:blood supply; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D007368:Interferometry; D008027:Light; D010857:Pigment Epithelium of Eye / Q000473:pathology*; D012163:Retinal Detachment / Q000175:diagnosis*; D012167:Retinal Perforations / Q000175:diagnosis*; D014054:Tomography / Q000379:methods
chemical_list: D007208:Indocyanine Green