RETINAL PIGMENT EPITHELIUM APERTURE PRECEDING COLLAPSE OF VASCULAR AND AVASCULAR PIGMENT EPITHELIAL DETACHMENTS SECONDARY TO AGE-RELATED MACULAR DEGENERATION.

Purpose: To describe retinal pigment epithelium (RPE) aperture preceding the collapse of RPE detachments (RPEDs) in eyes with neovascular and nonneovascular age-related macular degeneration (AMD). Methods: Medical records from five patients with RPE aperture associated with vascular and avascular RPEDs were reviewed between 2010 and 2021 at the New England Eye Center at Tufts Medical Center. Main outcome measures were analysis of RPE aperture characteristics and temporal course of RPED collapse. Results: Retinal pigment epithelium apertures were identified in six eyes from five women (mean age of 72.6 years). Two eyes had neovasacular AMD and four eyes had nonneovascular AMD. The RPE aperture initially appeared as a discontinuity at the apex of the RPED without rippling or retraction. Each aperture was associated with hypertransmission of optical coherence tomography signal into the choroid as well as hyperreflective foci. The mean time between the appearance of the RPE aperture and near-complete collapse of the RPED was 9 months. After RPED collapse, one eye developed choroidal neovascularization, three eyes progressed to geographic atrophy, one eye had recurrence of the RPED, and one eye remained unchanged. Conclusion: Retinal pigment epithelium aperture is a characteristic optical coherence tomography finding that can be observed in avascular or vascularized RPED secondary to AMD. Retinal pigment epithelium apertures precede RPED collapse, which are most likely to occur within 9 months of RPE aperture detection. [ABSTRACT FROM AUTHOR]