Acute laser-induced maculopathy with secondary exudative neovascular changes

Laser-related retinal injury is an uncommon but potentially sight-threatening cause of acute visual loss. Damage to the retinal pigment epithelium and Bruch's membrane may lead to exudation and, in selected cases, secondary choroidal neovascularisation. Industrial near-infrared diode lasers are particularly hazardous because they are invisible and can penetrate deeply into the retina. We report a welder in his early 40s who developed sudden visual loss after brief unprotected exposure to a 1060 to 1080 nm diode fibre laser. Examination showed a yellowish foveal lesion, macular haemorrhage and optical coherence tomography findings of acute laser maculopathy with presumed secondary exudative changes with possible early neovascular activity. He received one intravitreal bevacizumab injection 1 week after injury. At 2 months, vision improved from 20/80 to 20/20, with resolution of subretinal and intraretinal fluid and restoration of the foveal contour.