Spectralis optical coherence tomography findings in Welder's maculopathy.

Welder's maculopathy is a form of photochemical damage to the retina and is typically characterized by involvement of the outer retinal layers. Spectral domain optical coherence tomography (SD-OCT) imaging was performed in three eyes of two patients with clinical findings suggestive of Welder's maculopathy in occupational welders. A faceted foveal lesion characterized clinical examination and the SD-OCT line scans images showed a distinct discontinuity of the photoreceptor inner and outer segment (IS/OS) junction. The external limiting membrane (ELM) and the retinal pigment epithelial (RPE) layer remained intact at the site of IS/OS defect. SD-OCT imaging offers a noninvasive way of evaluating the microstructural changes at the fovea in Welder's maculopathy.

Evaluation of central, steady, maintained fixation grading for predicting inter-eye visual acuity difference to diagnose and treat amblyopia in strabismic patients.

Background: Diagnosis of amblyopia in preverbal strabismic patients is frequently made by binocular fixation preference (BFP) testing. The reports on reliability of BFP are equivocal. This study evaluated the reliability of BFP testing in patients with horizontal strabismus. Materials and Methods: This prospective observational study included patients with manifest, horizontal, comitant deviation >10 prism diopter (PD). Inter-eye acuity difference (IEAD) was calculated by converting Snellen visual acuity to logMAR and was compared with BFP testing. The fixation behavior of the non-preferred eye was evaluated by a single investigator as central or uncentral, steady or unsteady and maintained or unmaintained. Amblyopia was defined as the IEAD of >0.2 logMAR. Results: Of total 61 patients 36 were females and 36 had convergent squint, mean age 9.8 years. The correlation of BFP testing with IEAD was good for esotropia and exotropia. The sensitivity, specificity, positive and negative predictive value of central, steady, maintained (CSM) grading was 93%, 78%, 79%, and 93% respectively. Sensitivity and negative predictive values were higher in children aged four to nine years and anisometropia >1 diopter. The correlation between IEAD and lower grades of BFP testing was poor. Conclusions: CSM grading for BFP testing is useful for the detection of strabismic amblyopia but not useful to differentiate the depth of the amblyopia.