En Face Optical Coherence Tomography Imaging Ellipsoid Zone Regeneration in Laser-Induced and Solar Maculopathies

Abstract

The purpose of the study was to analyze imaging findings in spectral domain en face optical coherence tomography (SD OCT) in patients with laser‐induced and solar maculopathies focusing on the possible regeneration of the ellipsoid zone. In a retrospective case series of 3 patients (4 eyes) with solar maculopathy and 2 patients (3 eyes) with laser‐induced maculopathy who underwent a comprehensive ocular examination, ellipsoid zone (EZ) was segmented from SD OCT data. Evaluation of EZ in en face OCT revealed a hyporeflective lesion surrounded by a hyperreflective border. The area of EZ alteration was measured manually in en face OCT. All patients showed partial EZ regeneration. Mean EZ alteration decreased from 0.12 mm2 (range: 0.05–0.32) at baseline to 0.07 mm2 (range: 0.01–0.22) at last follow‐up (p = 0.018, mean follow‐up: 372 days; range: 115–592). Mean best visual acuity (BVA) improved from 20/36 at baseline to 20/30 (p = 0.018). In conclusion, en face OCT imaging clearly delineated the area of EZ alteration in patients with laser‐induced and solar maculopathies. Follow-up showed significant reformation of the EZ as well as improvement of BVA.

Natural Course of Solar and Laser-Associated Retinal and Macular Injuries at a Primary Care Hospital in Switzerland

“…In our previous publication, we reported a significant decrease in AAE in five patients (seven eyes) with solar and laser-associated retinopathies [2]. The present study verifies a significant decrease in AAE in a larger cohort of 11 patients (17 eyes).…”

“…Solar and laser-associated retinopathies are both retinal injuries due to exposure to high irradiance of electromagnetic waves in the visible spectrum 1 , 2 , 3 , 4 , 5 , 6 . Previous studies reported high rates of transmission through the ocular anterior segment in wavelengths ranging from 450 to 1000 nm, highlighting the variability of light sources potentially able to damage the retina 7 , 8 .…”

“…While both laser and solar-associated retinal injuries usually present with macula affection, laser-associated retinopathies can present with extrafoveal retinal damage, while solar retinal burns typically show central foveal involvement. Additionally, in laser-associated injuries, some cases present with track-like patterns of retinal damage, representing the movement of the laser focus during the exposure 1 , 2 . Photic injuries mostly occur in the outer retinal cell layers, as the outer segments of the photoreceptors and the retinal pigment epithelial (RPE) cells contain the majority of the light-absorbing molecules in the retina 3 , 6 .…”

“…In this study, we further evaluated findings in solar and laser-associated retinopathies. We focused on changes of alterations in the outer retina over time and visual recovery as described in our previous publication 2 .…”

Blastocyst-like Structures in the Peripheral Retina of Young Adult Beagles

“…However, ocular coherence tomography (OCT) examination frequently reveals that disruption of the ellipsoid zone is restricted in the foveolar region in various macular diseases, such as a macular microhole, acute retinal pigment epitheliitis, and laser-induced maculopathy [ 87 , 88 , 89 ], and OCT images of these lesions are at least partly regarded as a loss of cone outer segments [ 90 ]. Since the cone outer segments in the foveal retina of the primate fetus are tiny or absent [ 91 , 92 ], we infer that the foveolar cones lacking outer segments are immature cells with characteristics of retinal stem/progenitor cells resulting from dedifferentiation. Moreover, it appears that regeneration of the ellipsoid zone [ 93 , 94 ] is caused by redifferentiation of the dedifferentiated foveolar red/green cones.…”