The pathogenesis of tears of the retinal pigment epithelium.

We compared drusen in the fellow eye of patients with unilateral retinal pigment epithelial tears with those in an age- and sex-matched group of patients with unilateral primary neovascular disciform lesions. In the fellow eye of patients with tears, drusen were more confluent and manifested less fluorescence on angiography than in the comparison group. These observations are in accord with the concept that Bruch's membrane represents a significant barrier to fluid flow, and that fluid beneath detached pigment epithelium is derived in part or wholely from the pigment epithelium.