Spectral domain optical coherence tomography as a predictor of visual function in chronic solar maculopathy

Solar maculopathy can be a diagnostic challenge as clinical findings are often subtle and resemble other macular pathologies. Recent reports of chronic solar maculopathy have described characteristic loss of outer retinal layers. With the advent of spectral domain optical coherence tomography (SD-OCT), higher resolution of the chorioretinal architecture is possible and provides a unique means of assessing the organization and integrity of the retinal layers in cases of solar maculopathy. Two cases (four eyes) of chronic solar maculopathy were examined using Cirrus SD-OCT imaging (Carl Zeiss Meditec, Dublin, CA).

OCT scans revealed a large fragment of hyporeflectance at the level of the outer and inner photoreceptor layer with an abrupt discontinuation of the inner segment/outer segment junction. Visual acuity was minimally but permanently reduced in both cases.

These two cases demonstrate the reliability of SD-OCT as a biomarker of visual function in chronic solar maculopathy. The characteristic fragmented loss of the photoreceptor inner segment/outer segment junction correlates with decreased visual function in cases of solar maculopathy.