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We have had a member query regarding this concept.  

Can you please review the modelling of this concept as it is currently modelled as a 'separation' and a descendant of 'detachment' whereas other tears are modelled as 'ruptures'


There is also another concept in the same hierarchy 247158001 |Macular pigment epithelial detachment (disorder)| modelled the same way.  I am struggling to find any reference to 'macular pigment epithelial rip' but if rip is synonymous with tear then it would be correct to model with 125671007 |Rupture (morphologic abnormality)| such as for 95690009 |Retinal tear (disorder)|.  RPE detachment is modelled with 16640008 |Separation (morphologic abnormality)|.  As I can't find references to this rip, I am unsure if this is a tear or hole in the macula caused by RPE detachment, RPE detachment in the macular area or something else entirely but it looks like the concept needs improvement or inactivation if ambiguous.

It's an old concept that dates back to 1995 from NHS CV3.

I would appreciate your views.

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7 Comments

  1. Elaine Wooler

    Hi, does anyone have any comments on this one please?  Cindy Cai  Anthony Khawaja Eric Brown Ian Rodrigues Sally Baxter 

  2. Sally Baxter

    thanks Elaine Wooler I will say from a general ophthalmology perspective, I am not familiar with a "pigment epithelial rip." PED or pigment epithelial detachment, is quite a common term. I am not sure "rip" is in common usage given my lack of familiarity with this. I would think probably ok to retire/inactivate but curious to hear what others think as well.

  3. Ian Rodrigues

    Hi Elaine Wooler as a non-medical retina specialist I think this is mostly correct. I'm pretty certain is an actively used term and more so is recent years as it is a known (and potentially visually very significant) complication of (anti-VEGF) treatment of exudative macular degeneration (in the presence of a macular retinal pigment epithelium detachment).

    I think the modelling of this term is mostly correct - Retinal pigment epithelium is the appropriate anatomical site.

    I would suggest that a more appropriate morphology would be "tear" rather than "separation" (separation would only be appropriate for the parent term "retinal pigment epithelium detachment")

    I would suggest renaming the concept to "Macular retinal pigment epithelium tear" and adding a synonymous term "Macular retinal pigment epithelium rip" as it is more commonly referred to as a tear rather than rip.

    1. Michael Boland

      I am apparently old enough to remember RPE rips/tears which were more commonly described before the current era of treatment. Ian's approach seems appropriate.

  4. Cindy Cai

    Agree with Ian. RPE rip is something we still use clinically and counsel patients about. Locally, it's more commonly referred to as a rip than a tear.

  5. Sally Baxter

    Great to see the power of a group. Locally here we don't use the term "rip" (do use RPE tear) but clearly some variation in usage and helpful to not have inadvertently retired a still-used term! 

  6. Elaine Wooler

    Thank you all, power of the group indeed.