BACKGROUND AND OBJECTIVE: To investigate the progression of retinal atrophy in patients with retinal pigment epithelium (RPE) tears secondary to neovascular age-related macular degeneration. PATIENTS AND METHODS: In this retrospective case series, patients were analyzed at two high-volume referral centers. The extension of the areas without RPE was analyzed yearly from baseline to last examination through fundus autofluorescence (FAF) imaging using Region Finder (Heidelberg Engineering, Heidelberg, Germany). RESULTS: Sixteen eyes of 14 patients were included in the study. Mean follow-up was 70.11 months ± 15.5 months. The average area of atrophy was 6.89 mm 2 ± 5.4 mm 2 at baseline and 9.21 mm 2 ± 7.7 mm 2 at the last visit (P < .0001). This accounts for a progression of 0.36 mm 2 ± 0.46 mm 2 /year. In all cases, FAF revealed centrifugal extension of retinal atrophy. CONCLUSIONS: In this series, the area of retinal atrophy enlarged over time. Atrophy enlargement is characterized by centrifugal extension from the base of the tear.