Atlas of Ophthalmology

Instrinsic Repair of Laser Pointer Maculopathy within Two Months (Colour Image Posterior Pole, OCT, FFA)

Retina -> Light Toxicity
Patient: 13 years of age, male, BCVA 1.0 at OD, 0.6 at OS. Ocular Medical History: Young boy projected a handheld green laser pointer (532 nm green laser light, power < 5 mW, Class III Laser) through a window at the street. The reflected light from the glass leaded to a bilateral exposure of the macula. Two months later without any systemic therapy we found an instrinsic repair. General Medical History: empty. Main Complant: decreased vision after exposure to a green laser pointer. Purpose: to present instrinsic repair of Laser pointer maculopathy. Methods: Colour Image Posterior Pole, spectral-domain optical coherence tomography OCT, Fluorescein angiography FFA Findings: Colour Image Posterior Pole: just after laser exposure yellowish round spot in the foveal area. Colour Image Posterior Pole: two months after laser exposure partial resolution yellowish round spot, persistent alterations at the level of the retinal pigment epithelium. OCT: just after laser exposure disruption of the external limiting membrane, impairment of photoreceptor zone of the inner segments, and interdigitation zone. OCT: two months after laser exposure partial resolution of the outer retinal disruption compared to initial visit with persistent, small foveal photoreceptor defects, residual disruption of the outer retinal layer at the fovea remained unchanged. FFA: two months after laser exposure increased central avascular zone, late ill-defined leakage. Discussion: The Food and Drug Administration (FDA) identified 4 major classes of lasers (I–IV), of which the laser pointers belong to class IIIA (1). Diode laser pointers of red–orange (633–650 nm wavelength) are safer than the green–blue (400–500 nm). Injuries to the eye can occur within few seconds when the exposed to class III lasers that emit up to 5 mW power. Hossein et al. (2) reported, that after treatment with a systemic high-dose corticosteroid the initially visible hyperreflective band in the foveal region disappeared. Literature: (1) American National Standards Institute (2007) American national standard for safe use of lasers. Orlando: ANSI® Z136.1-2007, Revision of ANSI Z136.1-20 (2) Hossein M, Bonyadi J, Soheilian R, Soheilian M, Peyman GA. SD-OCT features of laser pointer maculopathy before and after systemic corticosteroid therapy. Ophthalmic Surg Lasers Imaging. 2011 Dec 16;42

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