OUTCOMES AND HEALING PROCESS OF RETINAL PIGMENT EPITHELIAL TEARS IN AMD PATIENTS: A 5-YEAR RETROSPECTIVE OBSERVATIONAL CASE SERIES.

PURPOSE: To evaluate the incidence of retinal pigment epithelium (RPE) remodeling after RPE tears in age-related macular degeneration (AMD) and assess its association with visual outcomes over a 5-year follow-up. METHODS: This retrospective observational study reviewed AMD eyes with RPE tears and a minimum follow-up of 5 years. Changes in best-corrected visual acuity (BCVA) were recorded, and the presence and delay to development of tear-associated retinal pigment epithelial proliferation (TARP) were evaluated. RESULTS: Twenty-six eyes from 23 patients were included. Mean age was 80.08 ± 6.67 years. Baseline BCVA was 0.83 ± 0.52 logMAR (Snellen equivalent 20/125), and final BCVA declined to 1.05 ± 0.54 logMAR (20/200) (p = 0.028). Mean follow-up was 6.25 ± 1.25 years. Both the greatest linear diameter and the area of RPE loss increased significantly from baseline to year 5 (p = 0.012 and p = 0.009, respectively). TARP was observed in 54.2% of eyes at 5 years, with a mean onset of 293 ± 258 days. Final BCVA was significantly worse in eyes with subretinal hemorrhage (p = 0.02), while the presence of TARP was not associated with visual outcome (p = 0.21). At 5 years, BCVA declined in both groups (with and without TARP), with no significant difference (p = 0.21). CONCLUSIONS: Approximately half of the eyes with RPE tears developed TARP, typically within the first year. TARP did not confer a visual benefit. These findings suggest that anatomical remodeling of RPE tears may occur without translating into improved visual outcomes.