Bilateral choroidal neovascular membrane in a child following intentional laser beam exposure

Area of Science:

• Ophthalmology
• Ocular Trauma
• Pediatric Ophthalmology

Background:

• Widespread use of recreational handheld laser devices increases the risk of ocular injuries.
• Children are particularly vulnerable to laser-induced eye damage due to accessibility and potential for intentional or unintentional exposure.
• Laser burn maculopathy is an emerging concern with increasing incidence in the pediatric population.

Purpose of the Study:

• To report a rare case of bilateral self-inflicted laser maculopathy in a young teen.
• To highlight the diagnostic challenges, including initial misdiagnosis as heredomacular dystrophy.
• To emphasize the effectiveness of multimodal imaging and anti-vascular endothelial growth factor (anti-VEGF) therapy in managing this condition.

Main Methods:

• Case report of a young teen with bilateral vision loss after intentional laser exposure.
• Multimodal imaging (e.g., OCT, fluorescein angiography) to diagnose maculopathy and choroidal neovascularization.
• Treatment with intravitreal anti-VEGF injections.

Main Results:

• Bilateral maculopathy with co-existing choroidal neovascular membranes was diagnosed via multimodal imaging.
• The patient initially presented with symptoms suggestive of heredomacular dystrophy, leading to delayed diagnosis.
• Anti-VEGF treatment resulted in significant resolution of the neovascular lesions and substantial vision improvement.

Conclusions:

• Self-inflicted laser eye injury can cause severe bilateral maculopathy, mimicking genetic conditions.
• Multimodal imaging is crucial for accurate diagnosis of laser-induced choroidal neovascularization.
• Early diagnosis and prompt anti-VEGF treatment can effectively manage laser maculopathy and restore vision.