DR. AKANKSHA RAI

DR. BRIJESH TAKKAR

Abstract

58 year diabetic and hypertensive male had acute Chronic serous chorioretinopathy in past. He presented with sudden-painless drop in visual acuity, RE-20/120 for 3 months and LE-20/25. On fundus examination 3 well-demarcated slate-gray lesions seen. Retracted RPE seen as well defined hyperpigmented line, area left behind by the tear was well circumscribed depigmented area.

Fundus autofluorescence showed 3 central hypo-autofluorescence and surrounding hyper-autofluorescent suggesting RPE tear. Area of bunched up RPE adjacent to RPE tear demonstrated hyperautofluorescence.

Fluorescein angiography showed large cresentric window defects corresponding to 3 areas of RPE tears with adjacent blocked fluorescence where RPE was scrolled up. On OCT RPE rip areas showed discontinuous RPE and is bunched up at edges causing back shadowing with RPE scrolled up at the edge. RPE rips are usually singular, related to Laser photocoagulation or anti-VEGF). Spontaneous RPE-rips are rare.