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Spectral-domain optical coherence tomography and fundus autofluorescence findings in a case of laser pointer-induced
Irene Rusu1, Jerome Sherman, Roberto Gallego-Pinazo
1*Department of Ophthalmology, New York University School of Medicine, New York, New York; †State University of New York College of Optometry, New York, New York; ‡Department of Ophthalmology, University and Polytechnic Hospital La Fe, Valencia, Spain; §Vitreous, Retina, Macula Consultants of New York, New York, New York; ¶LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, New York; and **Houston Retina Associates, Houston, Texas.
Purpose:
To describe the spectral-domain optical coherence tomography and fundus autofluorescence findings in a case of laser pointer-induced maculopathy.
Methods:
Observational case report of a patient with bilateral decreased visual acuity after exposure to a handheld green laser pointer.
Results:
A 15-year-old boy presented with decreased vision after exposure to a green laser pointer. Fundoscopy revealed gray and yellowish round spots in the foveal area of both eyes. Fundus autofluorescence imaging revealed subtle changes of the normal background macular autofluorescence of the right eye, with hyperautofluorescence dots in the fovea of the left eye. Spectral-domain optical coherence tomography showed a variety of changes of the outer retina and retinal pigment epithelium, with disruption of the external limiting membrane, the photoreceptor ellipsoid zone of the inner segments, and the interdigitation zone in the foveal region in both eyes. Six months after laser exposure, fundoscopic examination showed persistent alterations at the level of the retinal pigment epithelium in the fovea in both eyes. Fundus autofluorescence revealed mild but persistent changes of the normal autofluorescent macular background in both eyes. Spectral-domain optical coherence tomography showed partial resolution of the outer retinal disruption noted on his initial visit with persistent, small foveal photoreceptor defects in both eyes.
Conclusion:
Laser pointer maculopathy may disturb the outer retinal architecture in a manner evident on spectral-domain optical coherence tomography and fundus autofluorescence, resulting in decreased visual acuity. Proper warnings should accompany these devices and access to them by minors should be limited.
