Abstract
Various eye diseases can cause retinal pigment epithelium (RPE) tear. RPE tear is common in neovascular age-related macular degeneration (nAMD). The injection of anti-vascular endothelial growth factor (VEGF) increases the risk of PRE tear, the mechanism of which is a sudden change in intraocular pressure during drug injection, vitreous macular traction, destruction of the RPE tight junction barrier and secondary contraction and fibrosis of the choroidal neovascular membrane. The height of pigment epithelial detachment (PED) is an important risk factor for RPE tear in patients with nAMD after injection of anti-VEGF drugs. The diagnosis of RPE tears primarily relies on imaging studies，such as fundus photography、fundus autofluorescence、optical coherence tomography and so on. Regarding treatment, we must first determine whether the patient has a RPE tear, or whether there are risk factors related to the RPE tear, and then perform the corresponding personalized treatment. If possible, consider stem cell transplant alternatives. There is no proven method to prevent RPE tear so far. This article will review and summarize the research progress in the pathogenesis, risk factors, diagnosis, treatment and prevention of RPE tear caused by anti-VEGF drugs, and further improve the understanding of RPE tears，in order to provide reference for clinical work.
Highlights
Retinal pigment epithelium (RPE)tear was first reported in 1981 as a complication of neovascular age-related macular degeneration [1]
RPE tear can occur in the natural process of pigment epithelial detachment (PED) secondary to choroidal neovascular membrane (CNVM) [1], or may be associated with various treatments of neovascular age-related macular degeneration (nAMD), such as photodynamic therapy, laser photocoagulation, pupillary thermotherapy or anti-vascular endothelial growth factor therapy [1,2,3,4,5,6,7]
In 2006, Meyer [10] reported for the frist time that treating nAMD with intravitreal injection of bevacizumab will lead to RPE tear
Summary
Retinal pigment epithelium (RPE)tear was first reported in 1981 as a complication of neovascular age-related macular degeneration (nAMD) [1]. Since treating nAMD with the intravitreal injection of anti-VEGF drugs, RPE tear has been increasingly reported as a post-injection complication [8, 9]. In 2006, Meyer [10] reported for the frist time that treating nAMD with intravitreal injection of bevacizumab will lead to RPE tear. It is important to understand the pathogenesis, risk factors, diagnosis, treatment and prevention of RPE tear caused by anti-VEGF drugs in the treatment of nAMD
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