What PED size-related factor increases the risk of RPE tears?

In the context of pigment epithelial detachment (PED) and the accompanying risk of retinal pigment epithelium (RPE) tears, the height of the PED is a critical factor. Increased PED height can lead to greater mechanical stress on the overlying RPE. This stress arises from the difference in fluid dynamics and the structural integrity of the RPE, which may become compromised as the detachment becomes more pronounced.

When the PED height increases, it creates a larger vertical displacement, which may cause the RPE to stretch further than it normally would. This excessive stretching can cause the RPE to tear, leading to serious complications and potentially worsening the patient's condition. Studies have indicated that higher PEDs are indeed associated with a greater incidence of RPE tears due to this mechanical factor.

Other factors mentioned, such as decreased PED area, increased choroidal neovascularization (CNV) size relative to PED, and increased age of the patient, may contribute to the overall disease complexity, but they do not specifically heighten the mechanical stress on the RPE in the same way that increased PED height does. Consequently, focusing on the increase in PED height provides a clearer understanding of the risk associated with RPE tears.