Retinal pigment epithelium (RPE) tears are well recognised complications of pigment epithelial detachments (PED) in age related macular degeneration (AMD) and may arise spontaneously after trauma, photocoagulation, or photodynamic therapy (PDT).¹ Rosenfeld et al recently reported favourable results after intravitreal (IV) bevacizumab (Avastin) injection in neovascular AMD.² We present two patients, who developed an RPE tear after an intravitreal Avastin injection.

Case reports

The first case was a 64 year old man with an occult CNV with a PED in the right eye (fig 1A–C). His visual acuity (VA) gradually declined from 20/30 to 20/60. Four days after an uneventful IV injection of 0.05 ml Avastin, the patient noted a sudden drop in VA. His VA was 20/80 while fluorescein angiography (FA) and optical coherence tomography revealed a large RPE tear (fig 2A–C). The second case was a 84 year old woman with an occult CNV with a PED. Her VA was 20/60 when she required an IV Avastin injection. When …