follow-up visits was 9.567.4 and median time after RPE tear was 325 days and median follow-up time was 969 days. Subretinal blood was identiﬁed in 4 of 36 eyes (11.1%) at the ﬁrst presentation. The peripheral torn edge of the RPE layer presented as a sharp border in recent RPE tears. Over time, these edges became hazier and could be less well demarcated. FAF of RPE tears showed a hypoﬂuorescent area in the RPE denuded zone, indicating non-existing RPE. In 7 of 36 eyes (19.4%), hazy or speckled hyperﬂuorescent areas appeared in this region over time. The ﬁrst hazy or speckled hyper- ﬂuorescent areas were seen approximately 3 months after the acute event of RPE tear. When correlated with SD-OCT, dots of hyper-reﬂective materials were visible in the retina. These hyper-reﬂective dots (HRDs) had various diameters ranging from 10 to 120 mm on SD-OCT images. Clumps of HRDs were arranged as chains in the posterior segment of the photore- ceptor layer (POS) after the acute event of an RPE tear. These HRDs were present irrespective of the presence of subretinal or intraretinal ﬂuid. Clinical science HRDs arranged around intraretinal cysts were mostly small in diameter (approximately 10 mm, presumably intraretinal hard exudates), while those located in the outer retinal layers were large (up to 120 mm) and showed a high backscattering effect. These large HRDs created a shadowing effect; presumably they represented migrating intraretinal RPE cells, if no intraretinal or subretinal ﬂuid was present (ﬁgure 1). These HRDs were iden- tiﬁed in 30 of 36 eyes (83.3%) on SD-OCT scans. They were frequently encountered in the outer retinal layers and sometimes in the inner retinal layers. Some HRDs in the RPE denuded area were located directly on Bruch’s membrane. In FAF images, these migrating RPE cells appeared hyperﬂuorescent, while hard exudates appeared hypoﬂuorescent (ﬁgure 2). The border of the RPE denuded area presented as speckled hyperﬂuorescent areas in the FAF. In the corresponding SD-OCT, curled or redundant RPE layers were seen. Large HRDs with backscattering were frequently present in this region. Overall, 15 of 36 eyes (41.7%) showed a homogenous subre- tinal mass in the RPE denuded area. These subretinal masses showed choroidal hyper-reﬂectivity as a sign of not having Figure 1 A retinal pigment epithelium (RPE) tear 5 months after the acute event. Fundus autoﬂuorescence (A) image showed patchy hyperﬂuorescent spots in the RPE denuded area. The corresponding spectral-domain optical coherence tomography (B) showed hyper- reﬂective dots (arrows). Shadowing effect posterior to the hyper- reﬂective dots can be seen. Br J Ophthalmol 2012;96:1211–1216. doi:10.1136/bjophthalmol-2012-301750 Figure 2 A retinal pigment epithelium (RPE) tear 1 year and 2 months after the acute event. Fundus autoﬂuorescence (A) image of retinal pigment epithelium tear showed hyperﬂuorescent spots in the RPE denuded area. The corresponding spectral-domain optical coherence tomography image (B) showed hyper-reﬂective dots (arrow), indicating intraretinal RPE migration. 1213