Abstract

P 260

RPE tear and vitreoretinal traction in diabetic maculopathy

Nadia Kicová, Stefan Mennel
Augenklinik, Standort Marburg, Universitätklinikum Gießen und Marburg, Marburg

Introduction
Vitreoretinal traction may cause macular diseases or contribute as an additional factor in the pathogenesis. Actually, studies presented subretinal alterations caused by vitreoretinal traction. Thus it has been postulated that vitreoretinal traction may be a key factor in the pathogenesis of retinal pigment epithelium (RPE) – tear and subretinal choroidal neovascularization secondary to age-related macular degeneration. 
Methods
A 65-year-old patient complained progressive decrease of visual acuity especially in the right eye. Panretinal laser photocoagulation has been performed 3 years ago because of proliferative diabetic retinopathy. The patient suffers from diabetes mellitus type II since 20 years. Treatment with insulin is necessary since 9 years.
Result
Visual acuity decreased in the left eye from 0,3 to 0,1. Fluorescence angiography displayed a retinal ischemia within the central macula. Additionally a window defect could be demonstrated temporal of the macula adjacent to a central blockade-phenomenon nasal. Optic coherence tomography detected distinct vitreoretinal tractions and an elevation within the central macula. During vitrectomy tractions could be removed and a RPE tear was affirmed.
Conclusions
RPE tear have been already assigned to AMD and vitreoretinal traction postulated to be a potential cause. This case provides a further hint that preretinal tractions might cause or contribute to subretinal pathologies.

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