Pigment Epithelial Detachement: Pathophysiology, Diagnosis, and Treatments

Abstract

Pigment epithelial detachment (PED) is an important manifestation in various retinal diseases, particularly age-related macular degeneration (AMD), and has a significant impact on visual function decline. PED is associated with structural alterations of the retinal pigment epithelium (RPE) and plays a crucial role in determining visual prognosis. This study was conducted as a systematic literature review using 15 scientific articles published within the last five years, retrieved from databases including PubMed, Google Scholar, ScienceDirect, and SpringerLink. Articles were selected based on the inclusion criteria of peer-reviewed English-language studies focusing on PED. PED demonstrates diverse morphological types, including serous, drusenoid, fibrovascular, and hemorrhagic forms. It primarily results from degenerative processes, lipid accumulation, and choroidal neovascularization. Parameters such as size, composition, and variability are associated with visual outcomes. Optical Coherence Tomography (OCT) serves as the primary diagnostic modality, supported by OCT-A, fluorescein angiography (FA), and indocyanine green angiography (ICGA). PED is a significant biomarker in the diagnosis and prognosis of retinal diseases, particularly AMD. Anti-vascular endothelial growth factor (anti-VEGF) therapy improves anatomical features of PED, although functional visual improvement is not always observed. Therefore, a comprehensive approach with regular monitoring using advanced imaging modalities is essential to optimize clinical management and visual outcomes.