Spontaneous anatomical and functional recovery of bilateral electric shock maculopathy

Abstract

A 12-year-old boy presented with best-corrected visual acuity (BCVA) of 6/9 in both eyes following an episode of electric shock. Optical coherence tomography (OCT) showed disruption of the ellipsoid zone as well as retinal pigment epithelium (RPE) layer. Fundus autofluorescence (FAF) showed increased central hypoautofluorescence in both eyes. At 3-month follow-up, BCVA improved to 6/6 with OCT showing spontaneous resolution of maculopathy in both eyes with reorganized RPE layer and ellipsoid zone. To the best of our knowledge, this is the first case of bilateral electric shock maculopathy (ESM) with spontaneous anatomical as well as functional recovery. Ophthalmologists must be aware of various forms of ESM. OCT and FAF must be done in patients presenting with defective vision and history of electric shock for the diagnostic as well as prognostic evaluation.

Bilateral maculopathy and cataracts secondary to an accidental high-voltage electrical discharge

“…Very mild cases are characterized by RPE and photoreceptor layer disruption. [ 8 ] More commonly, there is an absence of the RPE and the outer retina forming an outer lamellar macular hole with an intact internal limiting membrane overlying the defect. These have been described as intraretinal macular cysts.…”

Simultaneous Cataract, Maculopathy and Optic Atrophy Secondary to High-Voltage Electrical Shock Injury

“…13 In the literature, maculopathy has been reported to stabilize and spontaneously recover during follow-up. Ranjan et al 15 reported functional and anatomical recovery in a case who developed an ellipsoid zone defect after an episode of electric shock during the 3-month follow-up. However, complete recovery was present in the mildest form of ESM.…”

Electric Shock Retinopathy: Case Report of a Late Retinal Manifestation

“…Macular cysts Sony et al 10 , Faustino et al 17 , Miller et al 5 , Lakosha et al 21 , Mitra et al, 19 Ranjan et al 9…”

“…Ranjan et al 9 stages. 4,10,15,17,18,[20][21][22] Retinal vascular damage and optic atrophy may also occur.…”

“…5 Because higher concentrations of melanin pigments are found in the macula (thicker and tightly packed RPE cells), it causes more production of heat and thermal damage; additionally, although the macula is the most affected site, the entire retina can be affected. 9 Macular manifestations include fullthickness macular hole, macular edema, and cysts. 8,10,11 The extent of tissue damage depends on the current intensity, tissue exposure time, and tissue resistance to the current.…”