An improvement in visual acuity accompanied by the development of RPE tear: A Case Report

Background One well-known side effect of retinal pigment epithelial detachment was retinal pigment epithelium tear. It was widely acknowledged as a disastrous event causing major decline in visual acuity. However, in our case, the retinal pigment epithelium tear led to the improvement of visual acuity. Case presentation: A 68-year-old male complained of blurry vision in his right eye over a month. A diagnosis of pachychoroid neovasculopathy was made. After three anti-vascular endothelial growth factor injections once a month, the choroidal neovascular membrane gradually diminished, while the pigment epithelial detachment expanded, subretinal fluid increased and the patient’s visual acuity deteriorated. Three months later, a retinal pigment epithelium tear was detected near the fovea, surprisingly along with a complete resolution of the subretinal fluid and a remarkable improvement of visual acuity. Conclusions Our case report presents a significant improvement in visual acuity after the retinal pigment epithelium tear development. The main reason was the drainage of pigment epithelial detachment by retinal pigment epithelial tear. The case indicated that surgical drainage of pigment epithelial detachment can be an effective treatment and needs further exploration.