title: Retinal pigment epithelium tears secondary to age-related macular degeneration: a simultaneous confocal scanning laser ophthalmoscopy and spectral-domain optical coherence tomography study.
abstract: OBJECTIVE
  To describe the morphology of retinal pigment epithelium (RPE) tears secondary to age-related macular degeneration by using high-resolution, spectral-domain optical coherence tomography (SD-OCT).
  
  
  METHODS
  For simultaneous topographic and tomographic in vivo imaging, confocal scanning laser ophthalmoscopy and spectral-domain optical coherence tomography were applied in combination. Retina over the RPE-denuded area was particularly examined for signs of viable photoreceptors.
  
  
  RESULTS
  A total of 26 patients (28 eyes) were included in the study. The mean (SD) age of patients was 78 (8) years (age range, 62-91 years). In cases with recent RPE tears, external limiting membrane, photoreceptor inner and outer segment junction, and nonatrophic outer nuclear layer could be identified in the retina on the RPE-denuded area. Intact external limiting membrane, photoreceptor inner and outer segment junction, and nonatrophic outer nuclear layer could be seen in 1 patient for up to 325 days after the RPE tear. In fibrotic older RPE tears, these structures were atrophic.
  
  
  CONCLUSIONS
  In this study, signs for viable photoreceptors could be identified for up to 325 days after an RPE tear using spectral-domain optical coherence tomography. This finding is important to consider in future therapies aimed at rescuing photoreceptors after RPE tears.
authors.affiliation: Center of Ophthalmology, Department of Vitreoretinal Surgery, University of Cologne, Kerpenerstr 62, 50924 Cologne, Germany. acaramoy@yahoo.co.uk
authors.forename: Albert
authors.initials: A
authors.lastname: Caramoy
authors.forename: Bernd
authors.initials: B
authors.lastname: Kirchhof
authors.forename: Sascha
authors.initials: S
authors.lastname: Fauser
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002470:Cell Survival; D003430:Cross-Sectional Studies; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008268:Macular Degeneration / Q000150:complications*; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D020419:Photoreceptor Cells, Vertebrate / Q000473:pathology; D012167:Retinal Perforations / Q000175:diagnosis / Q000209:etiology*; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D041623:Tomography, Optical Coherence