SD-OCT Features of Laser Pointer Maculopathy Before and After Systemic Corticosteroid Therapy

Hossein, Mohammad; Bonyadi, Jabbarpour; Soheilian, Roham; Soheilian, Masoud; Peyman, Gholam A.

doi:10.3928/15428877-20111208-03

Cited by 42 publications

(42 citation statements)

References 8 publications

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“…A report of maculopathy induced by a laser pointer has documented similar though more discreet and unilateral pattern of injury. 5 While amyl nitrate poppers cause disruption of the inner segment/outer segment, the spectral domain OCT appearance differs considerably from what is presented here. The most striking finding in those cases is the presence of subretinal fluid and alteration of the orientation of the photoreceptors.…”

contrasting

confidence: 72%

Diagnostic and Therapeutic Challenges

Grewal¹,

Jampol²,

Fawzi³

et al. 2014

Retina

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A 52-year-old white woman was seen in the neuroophthalmology clinic as a referral from the neurosurgery service for flashing lights, floaters, and decreased peripheral vision in both eyes for the past 3 months. Her medical history included asthma, hypertension, Crohn disease (in remission and off steroids for the past 3 years), generalized anxiety disorder, panic disorder, acephalgic ocular migraines, fibromyalgia, Raynaud disease, gout, thrombophlebitis, a Rathke cyst (not affecting the visual pathway), a left paraclinoid carotid artery aneurysm, and a right-sided superior hypophyseal aneurysm. She had suffered a right-sided cerebrovascular accident 2 years before, after which the aneurysms were discovered and she had undergone endovascular coiling of the left paraclinoid aneurysm. Her current medications included alprazolam, loperamide, lithium, hydroxyzine, and temazepam. Her social history was significant for occasional alcohol consumption, she was a regular smoker, and she denied illicit drug use. She was allegedly allergic to 21 different medications.On examination, her vision was 20/30 in both eyes and her intraocular pressures were 12 in the right eye and 13 in the left eye. There was no afferent pupillary defect. Her color vision was normal. Anterior segment examination was normal, and a dilated examination of the left eye revealed a peripheral temporal retinal detachment, not involving the macula, with a bullous component inferiorly and two retinal holes superotemporally. The right eye was unremarkable. She underwent an uneventful surgical repair with an encircling scleral buckle, cryopexy, and drainage of subretinal fluid. Her postoperative course was significant for an unusual amount of pain and discomfort. Her vision was 20/300 in the left eye 2 weeks postoperatively. Six weeks postoperatively, she complained of suddenly losing her central vision in both eyes and noted that her color vision was much worse. Her vision was counting fingers at 3 feet in both eyes with symmetric yellowish lesions involving the fovea in both eyes (Figure 1). Fundus autofluorescence images and the near infrared images were unremarkable. The peripheral retina was attached on the buckle in the left eye, and there was no vitritis. The anterior

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contrasting

confidence: 72%

Diagnostic and Therapeutic Challenges

Grewal¹,

Jampol²,

Fawzi³

et al. 2014

Retina

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“…High-resolution optical coherence tomography (OCT) demonstrated morphological retinal changes such as focal loss or disruption of retinal layers (8,9,11,17,18,21,22), macular holes (12,13,23,24,26), and cystoid changes or thickening (12,17,19) in all patients. Findings associated with prolonged exposure additionally showed streak lesions and, subsequently, fibrotic changes (27).…”

Section: Study Characteristicsmentioning

confidence: 98%

“…A number of articles (9)(10)(11)16) have reported the use of prednisolone in different strengths both topically and systemically. In the long-term follow-up (>6 months), 28 of 36 patients showed an increase in visual acuity, while other patients showed stable visual acuity.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Using multimodal imaging, including OCT, injuries can be detected and closely followed-up. During the acute stage and in addition to disruption of the retinal pigment epithelium, the outer retina frequently exhibits hyperreflectivity, accompanied by persistent disruption of the outer retinal layers (8,9). Laser-induced macular holes may develop directly following exposure or in the further course (12,26,30,34,35).…”

Section: Visual Acuity Following Laser Pointer Injurymentioning

confidence: 99%

“…The treatment options for laser pointer injuries are limited. Systemic corticosteroids were used in differing regimes and with differing results following exposure; however, there are no clear recommendations on management as yet (9,30). The systemic use of corticosteroids showed a protective effect in animal models (40).…”

Section: Visual Acuity Following Laser Pointer Injurymentioning

confidence: 99%

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