Bilateral macular cyst after lightning visualized with optical coherence tomography

The authors report a 14-year-old girl who was struck by lightning with bilateral macular cyst that was diagnosed with optical coherence tomography (OCT). Her fundus examination revealed bilateral macular lesions that simulated macular holes. The Watzke-Allen sign was negative in the right eye and positive in the left eye. Fluorescein angiography showed a foveal window defect in both eyes. OCT demonstrated a small foveal cyst evident as a hyporeflective lucency, visible just anterior to the retinal pigment epithelium/choriocapillaris complex in both eyes. OCT seems to be useful in the evaluation of lighting maculopathy to rule-out full-thickness macular hole in these cases, and avoid unnecessary surgery.