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Multimodal imaging in handheld laser-induced maculopathy.

Kavita V Bhavsar1, Deanna Wilson2, Ron Margolis3

  • 1Vitreous 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; Department of Ophthalmology, New York University Langone Medical Center, New York, New York; Department of Ophthalmology, Columbia University, New York, New York.

American Journal of Ophthalmology
|December 3, 2014
PubMed
Summary

Handheld laser exposure can cause maculopathy. Self-inflicted laser injuries may lead to outer retinal streaks, while accidental or peer-inflicted injuries often cause focal foveal lesions.

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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Retinal Diseases

Background:

  • Handheld lasers are increasingly common, posing potential risks to vision.
  • Maculopathy, a disease of the macula, can result from various insults, including light exposure.
  • Understanding the specific ophthalmic consequences of laser exposure is crucial for diagnosis and management.

Observation:

  • A retrospective case series evaluated 3 patients with maculopathy following handheld laser exposure.
  • Multimodal imaging, including fundus autofluorescence and spectral-domain optical coherence tomography (OCT), was utilized.

Findings:

  • Repetitive, self-inflicted laser exposure resulted in bilateral outer retinal streaks in the macula and peripheral retina.
  • Spectral-domain OCT revealed vertical hyper-reflective bands at the outer retinal level corresponding to these streaks.
  • Accidental or peer-inflicted laser injuries presented as focal foveal lesions with ellipsoid loss on OCT.

Implications:

  • Outer retinal streaks are a distinct finding associated with self-inflicted handheld laser maculopathy.
  • Differentiating injury mechanisms (self-inflicted vs. accidental/peer-inflicted) is important for predicting clinical presentation and OCT findings.
  • These findings highlight the potential for significant retinal damage from seemingly innocuous handheld laser devices.