Photic maculopathy: OCT-angiography features of eight eyes
A Zahaf1, A Ben Abderrazek1, H Lajmi1
1Department of Ophthalmology, Internal Security Forces Hospital, 29 Rue Tahar Ben Achour, 2078, La Marsa, Tunis, Tunisia; Faculty of Medicine of Tunis, University of Tunis El Manar, 15 Rue Djebel Lakhdhar, 1007, Tunis, Tunisia.
Introduction And Objectives:
Photic maculopathy is a retinal condition caused by exposure to intense light sources, resulting in varying degrees of visual impairment. Optical coherence tomography angiography (OCT-A) offers high-resolution, non-invasive imaging of the retinal microvasculature, facilitating detailed assessment of vascular alterations linked to this pathology. This study aims to characterize the OCT-A features of photic maculopathy and to emphasize the utility of OCT-A in evaluating retinal damage and microvascular changes.
Materials And Methods:
This retrospective descriptive study included patients diagnosed with PM between September 2021 and September 2023. Inclusion required a history of intense or prolonged light exposure temporally related to visual symptoms, characteristic fundus and clinical findings, and multimodal imaging confirming focal outer retinal damage at the fovea. Patients with alternative diagnoses, poor-quality imaging, or incomplete records were excluded. Clinical evaluation included structural optical coherence tomography (OCT), OCT-A, fluorescein angiography, and visual function tests. Demographic and ophthalmic data were collected, and a literature review was conducted to support interpretation.
Results:
Eight eyes from six patients were analyzed: two bilateral cases of solar maculopathy, one unilateral welder's maculopathy, and three unilateral laser-induced maculopathies. All patients presented with reduced visual acuity. Fundus examination revealed a yellowish foveal lesion in seven eyes and retinal pigment epithelium changes in one. OCT showed consistent disruption of the outer retinal layers. OCT-A demonstrated an irregular foveal avascular zone in six eyes and reduced vessel density in the superficial capillary plexus in four eyes.
Conclusions:
OCT-A plays a critical role in detecting structural retinal damage and associated microvascular alterations, offering key insights into the underlying pathophysiology. This study emphasizes the added value of OCT-A in assessing retinal integrity and vascular changes, which may enhance diagnostic accuracy and guide the clinical management of photic maculopathy.
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