Two types of optical coherence tomographic images of retinal pigment epithelial detachments with different prognosis. (Scientific Correspondence).

Aims: To report the optical coherence tomographic (OCT) findings in retinal pigment epithelium (RPE) detachments.

Methods: 24 eyes were analysed by OCT and by fluorescein (FAG) and/or indocyanine green angiography.

Results: RPE detachments were classified by the OCT images into those with a partial or total highly reflective line in the area of the detachment (nine eyes), and those that showed the same reflex in the detached area as in other parts (15 eyes). The nine eyes had irregular hyperfluorescence by FAG, significantly larger detachments, and lower visual acuity than the 15 eyes.

Conclusion: The OCT showed that two types of RPE detachments are associated with eyes with different characteristics.

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Retinal pigment epithelial (RPE) detachments (PEDs) occur between the RPE basement membrane and the inner collagenous Bruch's membrane. (1) PEDs result from disorders of the flow of fluid from the retina to Bruch's membrane, (2) and are considered to be an important preclinical condition of age related macular degeneration.

Lewis reported that patients less than 55 years old have PEDs that are small, without choroidal neovascular membranes (CNVs), and have minimal impairment of vision. Conversely, lesions of older patients were larger with significant visual impairment. (3)

Optical coherence tomography (OCT) provides a cross sectional tomographic image of the retina and choroid, (4) and unlike fluorescein angiography (FAG) and indocyanine green angiography (ICG), it is a non-invasive and non-contact diagnostic technique. We have evaluated PEDs using OCT and report a new classification of the PEDs which is comparable with that found by angiography.

MATERIALS AND METHODS

Twenty four eyes from 23 consecutive patients (12 men and 11 women) with PEDs were examined between February 1998 to May 2001. The clinical findings are listed in the Table 1.

Statistical significance was determined by using the [chi square], unpaired …