Polarization-sensitive optical coherence tomography features of the repair tissue following retinal pigment epithelium tear and functional correlation with visual outcomes.

Purpose: To investigate changes in melanin distribution and retinal sensitivity following a retinal pigment epithelium (RPE) tear in neovascular age-related macular degeneration (nAMD).

Methods: Five cases of nAMD with RPE tears involving the fovea within 1 month of onset were examined. Using polarization-sensitive optical coherence tomography, entropy-a quantitative indicator of melanin distribution-was measured at baseline and 6 months at the level of Bruch's membrane. Retinal sensitivity was assessed with a microperimeter, and entropy was averaged across 25 grids within a 6-degree radius. The relationship between changes in entropy and retinal sensitivity was analyzed.

Results: Entropy significantly increased in the tear area (from 0.19 to 0.22, p=0.026), whereas it decreased in the non-tear area. Retinal sensitivity also significantly increased in the tear area (from 12.7 to 16.3 dB, p=0.002). Although entropy and retinal sensitivity were not directly correlated in each area, their changes were significantly correlated, regardless of area type. Changes in central grid entropy were associated with changes in logarithm of the minimum angle of resolution visual acuity.

Conclusion: Six months post RPE tear, entropy and retinal sensitivity increased in tear areas; entropy changes were linked to retinal sensitivity and visual acuity, indicating functional adjustments following the tear.