Original ArticleImproved Diagnosis of Retinal Laser Injuries Using Near-Infrared Autofluorescence
Section snippets
Methods
In this retrospective observational case series, patients with inadvertent retinal laser damage seen at 2 academic centers (Oxford Eye Hospital, Oxford, UK and the Department of Ophthalmology, University of Bonn, Bonn, Germany) were identified from their medical records. The standard imaging protocol for patients with retinal light damage included B-AF (excitation at 488 nm, barrier filter at 500 nm) and NIR-AF (excitation at 787 nm, barrier filter at 810 nm) imaging (HRA2; Heidelberg
Results
We identified 12 patients with a clinical diagnosis of retinal laser injury, 9 of whom confirmed a history of laser exposure (Table). Owing to bilateral involvement in 2 patients, 14 eyes were available for analysis. Eight patients were male, 4 were female; and mean age at presentation was 13.9 years ± 2.9 years standard deviation (range: 9-20 years). At initial presentation, 5 patients reported a central scotoma and 2 described blurred vision. Five patients reported no vision problems
Discussion
In this series, we demonstrate that NIR-AF imaging consistently reveals typical sharply demarcated, often grouped lesions in patients with retinal injuries confirmed to have had prior exposure to handheld lasers. Features on other imaging modalities including conventional color fundus photography, B-AF, and OCT were less consistent or specific. This characteristic appearance on NIR-AF may help in diagnosing patients who do not recall laser exposure and help differentiate other disease entities
Summary
NIR-AF imaging is useful for determining the pattern and extent of laser damage. Characteristic features on NIR-AF imaging may be of diagnostic value for differentiating retinal lesions with a similar appearance on other imaging modalities, and for identifying laser injuries where retinal changes are otherwise minimal and/or less specific. We recommend including NIR-AF imaging for all patients suspected of retinal laser injury, and for those in whom it is included in the differential diagnosis,
References (33)
- et al.
The new pretender: a large UK case series of retinal injuries in children secondary to handheld lasers
Am J Ophthalmol
(2016) - et al.
A case of recurrent, self-inflicted handheld laser retinopathy
J AAPOS
(2016) - et al.
Solar retinopathy in children
J AAPOS
(2015) - et al.
Macular telangiectasia type 2
Prog Retin Eye Res
(2013) - et al.
Near-infrared autofluorescence in choroideremia: anatomic and functional correlations
Am J Ophthalmol
(2019) - et al.
High-resolution imaging of the human retina in vivo after scatter photocoagulation treatment using a semiautomated laser system
Ophthalmology
(2010) - et al.
Eye hazards of laser 'pointers' in perspective
Br J Ophthalmol
(2016) Guidance - Laser radiation: safety advice
- et al.
Random testing reveals excessive power in commercial laser pointers
J Laser Appl
(2013) - et al.
Retinal injury following laser pointer exposure
Dtsch Arztebl Int
(2017)
Laser pointer-induced maculopathy: more than meets the eye
J Pediatr Ophthalmol Strabismus
Retinal burns from laser pointers: a risk in children with behavioural problems
Eye (Lond)
Laser-induced photic injury phenocopies macular dystrophy
Ophthalmic Genet
Full-thickness macular hole secondary to high-power handheld blue laser: natural history and management outcomes
Am J Ophthalmol
Multimodal imaging in handheld laser-induced maculopathy
Am J Ophthalmol
In vivo fluorescence of the ocular fundus exhibits retinal pigment epithelium lipofuscin characteristics
Invest Ophthalmol Vis Sci
Cited by (9)
Ophthalmic phenotyping: Imaging
2022, Clinical Ophthalmic Genetics and GenomicsMultimodal imaging in phototoxic maculopathy: description of findings in a series of 12 patients
2021, Archivos de la Sociedad Espanola de OftalmologiaIncidence and long-term outcome of laser pointer maculopathy in children
2023, International OphthalmologyComparing six cases of external macular holes and literature review
2023, Revista Brasileira de OftalmologiaThe magic mirror: a novel intraoperative monitoring method for parathyroid glands
2023, Frontiers in EndocrinologyIncidence and long-term outcome of laser pointer maculopathy in children
2022, Research Square
Supplemental Material available at AJO.com.