title: Spontaneous large serous retinal pigment epithelial tear.
abstract: OBJECTIVE
  To report cases of spontaneous retinal pigment epithelial (RPE) tear complicating serous pigment epithelial detachment (PED).
  
  
  METHODS
  The records of 3 Asian patients with spontaneous giant RPE tear were reviewed retrospectively by including clinical presentation, angiography, optical coherence tomography, fundus autofluorescence imaging, and visual outcome.
  
  
  RESULTS
  Three patients (4 eyes) were included in this study, with a mean age of 48.3 (42-56) years, and a mean follow-up period of 7.75 (4-18) months. Fundus examination in all patients showed giant RPE tear associated with bullous PED. Two cases had a history of prior corticosteroid use, and 1 had no history of medication use. All 3 patients developed spontaneous resolution of subretinal fluid with no treatment. However, in patients who used corticosteroids, initial progression of the tear and subretinal fluid were observed despite ceasing medication. On subsequent follow-up, an incomplete RPE regeneration was demonstrated by fundus autofluorescence imaging, and choroidal neovascularization developed in 1 patient.
  
  
  CONCLUSIONS
  Large PED with RPE tear is a rare manifestation. When the fovea is spared, visual prognosis is favorable. No specific treatment is required, but careful choroidal neovascularization monitoring should be performed.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Voraporn
authors.initials: V
authors.lastname: Chaikitmongkol
authors.forename: Direk
authors.initials: D
authors.lastname: Patikulsila
authors.forename: Janejit
authors.initials: J
authors.lastname: Choovuthayakorn
authors.forename: Nimitr
authors.initials: N
authors.lastname: Ittipunkul
authors.forename: Paradee
authors.initials: P
authors.lastname: Kunavisarut
keywords: Pigment epithelial detachment; Retinal pigment epithelial rip; Retinal pigment epithelial tear