Laser-Induced Photic Injury Phenocopies Macular Dystrophy

To describe the phenotypes associated with laser-induced retinal damage in children. Five patients with maculopathy and reduced visual acuity associated with laser pointer use were evaluated. Best-corrected visual acuity, retinal structure, and function were monitored with color fundus, infrared (IR...

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Bibliographic Details
Published in:Ophthalmic genetics 2016-01, Vol.37 (1), p.59-67
Main Authors: Zhang, Lijuan, Zheng, Andrew, Nie, Hongping, Bhavsar, Kavita V, Xu, Yu, Sliney, David H, Trokel, Stephen L, Tsang, Stephen H
Format: Article
Language:English
Subjects:
Adolescent
Child
Electroretinography
Eye Injuries - diagnosis
Eye Injuries - etiology
Eye Injuries - physiopathology
Female
Humans
Lasers - adverse effects
Male
Optical Imaging
Phenotype
Photoreceptor Cells, Vertebrate - physiology
Retina - injuries
Retina - physiopathology
Retinal Dystrophies - diagnosis
Retinal Dystrophies - etiology
Retinal Dystrophies - physiopathology
Retinal Pigment Epithelium - physiopathology
Tomography, Optical Coherence
Visual Acuity - physiology
Visual Field Tests
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Summary:To describe the phenotypes associated with laser-induced retinal damage in children. Five patients with maculopathy and reduced visual acuity associated with laser pointer use were evaluated. Best-corrected visual acuity, retinal structure, and function were monitored with color fundus, infrared (IR), and red-free images, fundus autofluorescence (AF), spectral domain-optical coherence tomography (SD-OCT), and full-field electroretinography (ERG). All five laser pointer injury patients had retinal lesions resembling a macular dystrophy (one bilateral and four unilateral). These lesions were irregular in shape but all had a characteristic dendritic appearance with linear streaks radiating from the lesion. Photoreceptor damage was present in all patients, but serial OCT monitoring showed that subsequent photoreceptor recovery occurred over time in the eyes of at least four patients. One patient also had bilateral pigment epithelial detachments (PED). Both hyper- and hypoautofluorecence were observed in the laser damage area. In general, OCT and IR images are quite useful to diagnose laser damage, but AF is not as sensitive. Laser pointer damage in children can occasionally be misdiagnosed as a macular dystrophy disease, but the distinctive lesions and OCT features are helpful for differentiating laser damage from other conditions.
ISSN:1381-6810
1744-5094
DOI:10.3109/13816810.2015.1059458