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What is Pigment Epithelial Detachment?

Pigment epithelial detachment is a condition that happens when specific layers of cells behind your eye come apart, or get detached. This kind of detachment happens when you have extra fluid or other material under a layer of cells in the back of your eye, called the retinal pigment epithelium (RPE).1 This material can include fluid, proteins, fibrous tissue, or blood vessels.2

The retinal pigment epithelium is found behind the retina. The retina is a thin layer of light-sensitive cells at the back of the eye. It is responsible for receiving light energy through the pupil and transforming that into signals that get processed in the brain.3 This is the basic process that enables us to see. Pigment epithelial detachments can disrupt your vision.

What causes PED?

When you have PED, your health care team will want to understand its underlying cause. This will help them know how to treat the condition as well as predicting how well your vision will recover. There are many causes of PED. The most common are age-related macular degeneration (AMD) and central serous chorioretinopathy.1

What is AMD?

Age-related macular degeneration happens when part of your retina, called the macula, is damaged. This leads to impaired vision, particularly in the center of your eye. A relatively common condition, AMD is the leading cause of vision loss in people aged 50 and older.4

What is central serous chorioretinopathy?

Central serous chorioretinopathy happens when fluid leaks from a layer of cells called the choroid. The choroid is next to the RPE, behind the retina in the eye.5

Other causes

Other causes of PED are much more rare and include2:

  • Genetic diseases
  • Kidney diseases
  • Inflammatory syndromes
  • Side-effects of certain infections
  • Certain cancers
  • Side-effects of certain surgical or medical procedures

What are symptoms of PED?

People experiencing pigment epithelial detachment often describe blurry vision and/or partial loss of vision. Others describe a dark shadow over their vision or the sense that they are looking through a curtain or layer of fabric.4

How is PED diagnosed?

There are many different forms of PED, depending on what kind of fluid or other material is separating the cell layers inside your eye. Your doctor will perform a visual examination to look inside your eyes as a first step in diagnosing your particular condition.2

Other imagining techniques using special eye drops and cameras may help reveal specific features of your PED. This can help your provider understand more about what’s causing the condition and how to treat it.2

How do you treat PED?

There is no current proven treatment for PED caused by fluid build-up. Some people with this condition get better on their own.1,2 There are a few proven methods for treating PED that is caused by the growth of new blood vessels behind the eye. These include lasers, steroid injections, and certain medicines that block the formation of new blood vessels.2

The location, size, and duration of your detachment may make a difference in how likely you are to regain your vision or whether it may get worse over time.2

  1. 1 Williams, G. Pigment Epithelial Detachment. Ask an Ophthalmologist. American Academy of Ophthalmology. Available at https://www.aao.org/eye-health/ask-ophthalmologist-q/information-on-pigment-epithelial-detachment. Accessed 10/29/19.
  2. Thorell, M., Hacopian, A., Kiernan, D., et al. Pigment Epithelial Detachment. EyeWiki. American Academy of Ophthalmology. Available at https://eyewiki.aao.org/Pigment_Epithelial_Detachment. Accessed 10/29/19.
  3. What is the Retina? VMR Institute. Available at https://www.vmrinstitute.com/what-is-the-retina/. Accessed 10/29/19.
  4. Boyd, K. What is Macular Degeneration? American Academy of Ophthalmology. Available at https://www.aao.org/eye-health/diseases/amd-macular-degeneration. Accessed 10/29/19.
  5. Porter, D. What is Central Serous Chorioretinopathy? American Academy of Ophthalmology. Available at https://www.aao.org/eye-health/diseases/what-is-central-serous-retinopathy. Accessed 10/29/19.

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