How does a Fibrovascular PED form?

Fibrovascular pigment epithelial detachment (PED) is primarily formed through the entrance of new blood vessels into the subretinal pigment epithelium (RPE) space. This pathological process typically occurs in conditions such as age-related macular degeneration (AMD), where exudative changes lead to choroidal neovascularization (CNV).

When these new vessels penetrate the membrane beneath the RPE, they create a detachment of the pigment epithelium due to the accumulation of fluid and blood. This is significant in the context of AMD because the presence of fibrovascular PED is associated with visual loss and disease progression. The structural changes within the retinal layers contribute to the overall impact on retinal function and vision.

Other mechanisms like hyperproliferation of RPE cells can lead to changes in the RPE itself, but this does not directly account for the formation of a fibrovascular PED. Similarly, retinal ischemia might contribute to the conditions that promote neovascularization but is not the primary mechanism for forming a PED. Mechanical trauma can cause direct damage to the retina, but it also does not directly lead to the typical formation of fibrovascular PEDs as seen in AMD.