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

Abstract

SUMMARYThree-dimensional spectral domain optical coherence tomography was performed in a 26-year-old man with chronic exposure to welding arc. Advanced macular visualisation provided significant findings of inner segment-ellipsoid zone disruption with the presence of cystoid changes and hyper-reflective material in the area of disruption. The external limiting membrane was intact in both the eyes. C-scan retinal pigment epithelium fit map of the left eye revealed a well-delineated defect whereas the right eye showed a poorly delineated smaller defect. The hyper-reflective material can be hypothesised to originate from the disrupted photoreceptor layer. The hyper-reflective material was more evident in the left eye which could be correlated with more marked diminution of vision and a prominent yellow lesion at the fovea. BACKGROUND

Maculopathy from an accidental exposure to welding arc

“…However, hyper-reflectivity in the external limiting membrane became apparent on OCT in their patients after 1 month 6. Other studies reported the OCT findings of chronic welding arc maculopathy as interruption in the IS/OS layer and the inner portion of the RPE 3 11 12. Saxena et al reported hyper-reflective material deposit in the disrupted region which may have resulted from reduced phagocytosis of RPE and increased accumulation of the cone OS 12.…”

“…Other studies reported the OCT findings of chronic welding arc maculopathy as interruption in the IS/OS layer and the inner portion of the RPE 3 11 12. Saxena et al reported hyper-reflective material deposit in the disrupted region which may have resulted from reduced phagocytosis of RPE and increased accumulation of the cone OS 12. Although the prognosis of welding-induced photic retinal injury is usually good, permanent complications are sometimes reported,9 and this difference in sequelae may reflect the severity of exposure and injury.…”

Clinical Photic Retinopathy: Mechanisms, Manifestations, and Misperceptions

“…Welding arcs can cause phototoxic macular injuries largely indistinguishable from solar retinopathy, as shown in Fig. 8a [136,[210][211][212][213]. Retinal temperature increases are typically too low for photocoagulation [6,133], but thermal damage may be involved in severe injuries [214,215].…”