Pseudo-pigment epithelial detachment and retinal pigment epithelium bumps in high-myopia

Session Details

Session Title: Free Paper Session 17: Imaging II

Session Date/Time: Saturday 09/09/2017 | 08:00-09:30

Paper Time: 08:06

Venue: Room 120

First Author: : A.Marchese ITALY

Co Author(s): :    A. Carnevali   R. Sacconi   T. Centoducati   L. Querques   F. Bandello   G. Querques              

Abstract Details


To report on the presence of pseudo-pigment epithelial detachments (pseudo-PEDs) and retinal pigment epithelium (RPE) bumps in high-myopia, and to describe the distinctive features from pathological PEDs and choroidal neovascularizations (CNVs).


Department of Ophthalmology, University Vita-Salute, IRCCS San Raffaele, Milan, Italy.


Retrospective cross-sectional analysis of consecutive patients with high-myopia presenting between September 2015 and February 2017 at the Medical Retina & Imaging Unit, University Vita-Salute, IRCCS San Raffaele Hospital in Milan. All patients underwent spectral domain optical coherence tomography (OCT) and elevations of the RPE were studied. Pseudo-PEDs and RPE bumps were defined as RPE elevations 100 m and <100 m, respectively, without any evidence of pathological sub-RPE material. Multimodal imaging was analyzed to confirm the alterations of the RPE and choroid.


One hundred and ninety-five eyes of 101 patients were included. Pseudo-PEDs were identified in 39 out of 195 eyes (20%) and RPE bumps in in 60 out of 195 eyes (30.8%) on structural OCT. In all eyes, pseudo-PEDs and RPE bumps corresponded to large choroidal vessels that elevated the retinal pigment epithelium. Patchy, diffuse or CNV-related atrophy were more common in eyes with pseudo-PED and/or RPE bumps (60.6% vs 34.4%; p<0.05). Internal double round hyper-reflectivity and presence of a large choroidal vessel elevating the RPE were the distinctive features from pathological PEDs and choroidal neovascularizations (CNVs).


Pseudo-PEDs and RPE bumps are frequently observed in highly myopic eyes and they result from the presence of an underlying large choroidal vessel. They are more likely to appear in highly myopic eyes with advanced choroidal atrophy. To prevent unnecessary treatments, they should be distinguished from pathological PEDs and CNVs.

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