Multifocal electroretinogram and Optical Coherence tomography spectral-domain in arc welding macular injury: a case report

Abstract

Backgroundthe purpose of this study was to report a binocular photic retinal injury induced by plasma arc welding and the follow-up after treatment with vitamin supplements for a month. In our study, we used different diagnostic tools such as fluorescein angiography (FA), optical coherence tomography (OCT) and multifocal electroretinogram (mfERG).Case presentationin the first visit after five days from arc welding injury in the left eye (LE) the visual acuity was 0.9 and 1.0 in the right eye (RE). FA was normal in both eyes. OCT in the left eye showed normal profile and normal reflectivity and one month later, a hyperreflectivity appeared in the external limiting membrane (ELM). The mfERG signal in the LE was 102.30 nV/deg2 five days after the injury and 112.62 nV/deg2 after one month and in the RE respectively 142.70 nV/deg2 and 159.46 nV/deg2.Conclusionsin cases of retinal photo injury it is important for the ophthalmologist to evaluate tests such as OCT and the mfERG in the diagnosis and follow-up of the patient because the recovery of visual acuity cannot exclude the persistence of phototoxic damage charged to the complex inner-outer segment of photoreceptors.

Maculopathy from an accidental exposure to welding arc

“…These findings are similar to a previous report on OCT findings in solar retinopathy 10. Cellini et al and Choi et al reported no OCT findings in acute welding retinopathy, which may be related to differences in light intensity and protection 6 8. However, hyper-reflectivity in the external limiting membrane became apparent on OCT in their patients after 1 month 6.…”

“…Hence, studies covering a representative number of patients have been rare, and phototoxic maculopathy has been documented in casuistic reports only 5. There have been some case reports of retinopathy caused by welding arc 6–9. A case–control study with 40 participants reported that occupational welders have a higher risk of phototoxic maculopathy, and abnormalities in optical coherence tomography (OCT) could be detected earlier than visual symptoms 3.…”

A case of accidental retinal injury by cosmetic laser

“…Current medical treatment for retinal laser injuries is systemic administration of anti-inflammatory and antioxidant drugs, typically corticosteroids 3,4 and vitamins, that are believed to limit retinal injury, reduce vision loss, and promote recovery. 5 Eye ( We report a case of cat scratch disease with manifestation of multifocal chorioretinal lesions and we document the imaging findings through spectral domain optical coherence tomography (SD-OCT) during the course of the disease from early presentation until the resolving of symptoms. …”

“…These alterations have either been hypothesized or shown to disrupt RPE, photoreceptor, and ganglion cell function. 1,5,6 The partial reversibility of the patient's visual function may reflect the normalization of her homocysteine levels after treatment. This case suggests that vitamin B12 deficiency should be considered in the differential diagnosis of elderly patients presenting with worsening vision and macular findings that might otherwise be mistaken for new or worsening AMD.…”

Three-dimensional spectral domain optical coherence tomography in chronic exposure to welding arc

“…Cellini et al 5 reported subfoveal external limiting membrane hyper-reflectivity in a case of acute exposure to welding arc. Choi et al 6 reported acute welding arc injury with diminution of vision without any retinal changes on SD-OCT. Vedantham7 reported, in chronic welder arc exposure, presence of a hyporeflective space between the two retinal outer hyper-reflective layers.…”