Choroidal thickness in retinal pigment epithelial tear as measured by spectral domain optical coherence tomography

Purpose: To evaluate the choroidal thickness with spectral domain optical coherence tomography in subjects with retinal pigment epithelial (RPE) tear compared with the choroidal thickness of their fellow eye. Methods: For this cross-sectional investigation, seven eyes of seven patients with neovascular age-related macular degeneration and RPE tear in one eye imaged with spectral domain optical coherence tomography were identified. Choroidal thickness was measured from the posterior edge of the retinal pigment epithelium to the choroid/sclera junction at 500 μm intervals up to 2,500 μm temporal and nasal to the fovea in both the eye with the RPE tear and the eye with intact RPE. All measurements were performed by two independent observers and averaged for the purpose of the analysis. Measurements were compared using paired t-test. Results: The average age of patients was 79 years (range, 66-88 years). All subjects had dome-shaped pigment epithelial detachments before RPE tear and no dome-shaped pigment epithelial detachments in the unaffected eye. Average subfoveal choroidal thickness in the eye with the RPE tear was 154.9 ± 10.1 μm. Average subfoveal choroidal thickness in the eye with intact RPE was 212.9 ± 10.6 μm (P = 0.035). Conclusion: There is a significant decrease in subfoveal choroidal thickness in the subjects with RPE tear compared with their fellow eye with intact RPE. It is unclear if this thinning is a consequence of or precedes the RPE tear. Further studies are necessary to prospectively follow choroidal thickness in subjects with dome-shaped pigment epithelial detachments.