Purpose: To report five cases of different types of Retinal Pigment Epithelium Detachment (RPED) treated with intravitreal injection of Bevacizumab (IVB)
Method: A interventional case series.
Results: There are three patients with idiopathic avascular serous RPED, and one of them combined with sub-neurosensory retina fluid. One case had RPED with macular hemorrhage due to blunt eye trauma. One case had RPED with age-related macular degeneration (AMD). All of the three patients with idiopathic avascular serous RPED revealed promising result with best correction visual acuity (BCVA) 20/20. RPED disappeared in two of the three patients. Sub-neurosensory retina fluid was reabsorbed. The patient of RPED with macular hemorrhage also revealed reattachment of RPED and rapid clearance of macula hemorrhage. BCVA of the patient was 20/25. There was no obvious improvement of visual acuity and fundus condition in the patient of RPED with AMD. The follow up periods were one to six months according to clinical response.
Conclusion: RPED is a non-specific anatomical alteration that may result from any number of choroidal disorders that disrupt the normal junction between the basement membrane of the RPE and the inner collagenous layer of Bruch’s membrane. The causes of RPED include vascularized PED that originated form fibrovascular membrane beneath RPE, hemorrhage beneath the RPE, confluent large drusen, idiopathic polypoid choroidal vasculopathy, retinal angiomatous proliferation idiopathic , central serous chorioretinopathy, and idiopathcally.
The treatment of RPED is variety and the benefit is still undetermined. We report five cases of RPED of different etiology with management of IVB. Possible benefit of treatment was found in four patients, including idiopathic avascular serous RPED and RPED due to trauma. Further large case series or study is needed to investigate the effect of IVB in RPED, the candidate who may have benefit from IVB, and the mechanism of treatment. | 
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