Retinopatía por puntero láser: presentación de dos casos / Handheld laser maculopathy: two case reports

El uso indebido de los punteros láser, especialmente el recreativo en los niños, puede causar lesiones retinianas que amenazan la visión. El daño retiniano que producen no está bien caracterizado, debido a que la mayoría de las publicaciones son casos aislados o series pequeñas. El tratamiento y el pronóstico visual es variable según la morfología del daño macular que presenten. En algunos casos, no existe tratamiento, y pueden evolucionar a la curación espontánea; sin embargo, otros precisan cirugía. En una serie de 13 casos, uno requirió cirugía, mientras que el resto necesitó solo observación. De estos 13 casos, 3 pacientes se curaron en forma espontánea, con agudeza visual de 10/10.Se describen dos pacientes de 16 y 12 años con disminución de agudeza visual tras el uso indebido de punteros láser. En el fondo de ojo, presentaron alteraciones maculares. La agudeza visual de ambos se recuperó completamente sin tratamiento.

The improper use of laser pointers, especially for recreational use in children, may cause sight-threatening retinal injuries. The retinal damage it is not well characterized because most publications are isolated cases or small series.The treatment and visual prognosis are variable according to the morphology of the macular damage. In some cases, there is no treatment, and spontaneous healing can be developed; however, others require surgery. In a series of 13 cases, 1 required surgery and the rest observation; 3 patients obtained a spontaneous healing with visual acuity of 10/10.We describe two patients aged 16 and 12 years with decreased visual acuity. Macular alterations appear in the fundus of the eye. The visual acuity of both recovered completely without treatment

A Case of Maculopathy from Handheld Green Laser Pointer

PURPOSE: To report a case of successfully treated maculopathy after exposure to a handheld green laser pointer beam. CASE SUMMARY: A-15-year-old patient visited our clinic complaining of visual disturbance in the left eye 5 days earlier after exposure to a handheld laser pointer with 532 nm wavelength green beam for 5 seconds. His best corrected visual acuity was 20/50 in the left eye. On fundus examination, a yellowish retinal scar was observed at the foveal area. The spectral domain optical coherence tomography (SD-OCT) showed cone outer segment tip line and inner segment/outer segment line disruption, external limiting membrane line and retinal pigment epithelial complex injury related to laser pointer exposure. We started occlusion therapy, oral prednisolone and, antioxidant treatment on his left eye for 2 weeks. The best corrected visual acuity was 20/20 in the left eye at 1 month after treatment. However, spectral domain optical coherence tomography showed a scar remained in the retinal pigment epithelial complex of the macular region of his left eye while the external limiting membrane line was restored and inner segment/outer segment line was partially restored. CONCLUSIONS: Maculopathy can result from exposure to a handheld green laser pointer. Occlusion therapy, oral prednisolone and, antioxidant treatment might be helpful for recovery of visual acuity and restoration of external limiting membrane line.

A Case of Green Laser Pointer Injury to the Macula

PURPOSE: We report a case of macular injury by accidental exposure to a green laser pointer. CASE SUMMARY: A 25-year-old man had an acute reduction of visual acuity in his right eye two years ago after accidental exposure to a green laser pointer for a few seconds. The patient's best corrected visual acuity was counting fingers in his right eye. Fundus examination and optical coherence tomography showed a macular hole and a linear retinal scar in his right eye. CONCLUSIONS: Green laser pointers may cause macular damage after exposure of just a few seconds, which can lead to irreversible reduction of visual acuity.

Maculopathy from Red Laser Pointer

PURPOSE: To report a case of maculopathy following exposure to a red laser pointer beam. PATIENT AND METHODS: A 12-year-old boy visited our clinic due to decreased visual acuity in the right eye after 2 months after exposure to a red laser pointer beam for 10 to 20 seconds at a distance of 3 m. RESULTS: Uncorrected visual acuity was 0.1 and 0.9 in the right and left eyes, respectively. The best corrected visual acuity of the right eye was 0.15. Upon funduscopic examination, a yellowish degeneration was observed in the macular area. Fluorescence angiography showed hyperfluorescent window defect that may have been a retinal pigment epithelial defect related to laser pointer exposure. There were no specific findings in electroretinogram, and the boundary between the photoreceptor and retinal pigment epithelium was ambiguous as determined by optical coherence tomography. A Humphrey automated visual field test revealed generalized central field defect, although his cooperation was not sufficient. CONCLUSIONS: Red laser pointer should be used carefully, as their misuse can result in retinal damage, especially in inadequately used macula.