Lijuan Zhang1,2, Andrew Zheng1, Hongping Nie3, Kavita V Bhavsar4, Yu Xu1, David H Sliney5, Stephen L Trokel1, Stephen H Tsang1. 1. a Department of Ophthalmology , Edward S. Harkness Eye Institute of Columbia University , New York , NY , USA . 2. b Shanxi Eye Hospital, Shanxi Medical University , Taiyuan , China . 3. c Department of Ophthalmology , Peking University First Hospital , Beijing , China . 4. d Casey Eye Institute, Oregon Health and Science University , Portland , Oregon , USA , and. 5. e Bloomberg School of Public Health, the Johns Hopkins University, Division of Environmental Health Engineering , Baltimore , MD , USA.
Abstract
OBJECTIVE: To describe the phenotypes associated with laser-induced retinal damage in children. METHODS: 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). RESULTS: 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. CONCLUSIONS: 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.
OBJECTIVE: To describe the phenotypes associated with laser-induced retinal damage in children. METHODS: 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). RESULTS: All five laser pointer injurypatients 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. CONCLUSIONS: 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.
Authors: Johannes Birtel; Wolf M Harmening; Tim U Krohne; Frank G Holz; Peter Charbel Issa; Philipp Herrmann Journal: Dtsch Arztebl Int Date: 2017-12-08 Impact factor: 5.594
Authors: Katie M Litts; Mali Okada; Tjebo F C Heeren; Angelos Kalitzeos; Vincent Rocco; Rebecca R Mastey; Navjit Singh; Thomas Kane; Melissa Kasilian; Marcus Fruttiger; Michel Michaelides; Joseph Carroll; Catherine Egan Journal: Transl Vis Sci Technol Date: 2020-03-30 Impact factor: 3.048