Morphologic and functional changes in solar retinopathy: a study by optical coherence tomography and fundus-related...

Solar retinopathy is caused by macular exposure to solar radiation and is mediated by photochemical and thermal mechanisms. Ultrastructural examination shows the retinal pigment epithelium (RPE) and the outer segments of the photoreceptors as the most susceptible to solar insult. The authors describe the optical coherence tomography (OCT-3 Stratus) and the fundus-related perimetry (MP-1 microperimeter) findings of the disease.

The authors performed a complete ophthalmologic examination in three patients with solar retinopathy, including two new, highly sensitive diagnostic tools, the OCT-3 and the MP-1, soon after solar exposure and again up to 18 months after diagnosis.

Symptoms and macular changes were similar in these three patients despite different exposures to solar radiation. On initial visit, the OCT scans revealed in all three patients an irregular inner high-reflective layer (I-HRL) that appeared fragmented and interrupted. In addition, the OCT images showed a hyperreflective lesion, which, in one patient, involved the full foveal thickness, and in two patients was confined to the outer half of the foveal layers. In two patients there was an associated reduced reflectiveness of the outer high-reflective layer (O-HRL). These OCT signs disappeared as early as 1 month follow-up. Fundus-related perimetry demonstrated, at the first visit, a significant reduction of retinal sensitivity in all patients, which was no longer evident at 1-month follow-up.

OCT may be an effective tool in diagnosing the acute phase of solar retinopathy and in differentiating it from other maculopathies. Fundus-related perimetry would seem to be a useful adjunctive method to better characterize the functional aspect of the disease.