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Solar retinopathy in children
Emily Gregory-Roberts1, Ye Chen2, C Alex Harper2
1Royal Victorian Eye and Ear Hospital, Australia; Royal Children's Hospital, Victoria, Australia.
Insights
Children viewing the sun can develop solar retinopathy, causing persistent retinal damage. Spectral domain optical coherence tomography (SD-OCT) reveals foveal pathology even with normal visual acuity.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Retinal Imaging
Background:
- Solar retinopathy is a rare condition caused by direct sun viewing.
- Pediatric solar retinopathy is less understood than adult cases.
Observation:
- A case series of 3 children (5 eyes) with solar retinopathy following sun viewing events.
- Patients underwent visual acuity testing, fundus examination, and spectral domain optical coherence tomography (SD-OCT).
Findings:
- SD-OCT identified foveal pathology in all affected eyes, irrespective of visual acuity.
- Photoreceptor ellipsoid and interdigitation zones were disrupted in all eyes.
- Outer nuclear layer and external limiting membrane disruptions correlated with decreased visual acuity and resolved over time.
- Ellipsoid and interdigitation zone abnormalities persisted in some eyes at 3-5 months follow-up, despite good visual acuity.
Implications:
- Solar retinopathy in children can lead to persistent retinal damage.
- SD-OCT is crucial for detecting subtle foveal damage in pediatric solar retinopathy.
- Long-term visual consequences may exist even with apparent visual recovery.
Purpose:
To describe the visual acuity, fundus appearance, and spectral domain optical coherence tomography (SD-OCT) findings in 5 eyes of 3 children with foveal damage from solar retinopathy.
Methods:
This was a prospective, observational case series of children who presented to the emergency department at the Royal Victorian Eye and Ear Hospital after having directly viewed the Sun during the transit of Venus on June 6, 2012, or the partial eclipse of the Sun on November 14, 2012. All patients underwent visual acuity testing, dilated fundus examination, and SD-OCT imaging.
Results:
The 3 patients' ages at presentation were 8, 10, and 11 years. Best-corrected visual acuity in the affected eyes ranged from 20/20 to 20/40 on presentation. Significant foveal pathology was identified on SD-OCT in all 5 eyes, even when visual acuity was normal. At presentation, all eyes showed disruption of the photoreceptor ellipsoid zone and the interdigitation zone on SD-OCT. Additionally, in those eyes with decreased visual acuity, there was disruption of the outer nuclear layer and/or external limiting membrane. At 3-5 months' follow-up, the outer nuclear layer and external limiting membrane lesions had resolved; however, in some eyes the ellipsoid and interdigitation zone abnormalities persisted at 5 months' follow-up, even in the presence of best-corrected visual acuity as good as 20/12.5.
Conclusions:
Solar retinopathy in children can cause persistent damage to multiple retinal layers despite recovery of good visual acuity.
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