Rapid response to systemic steroid in macular alexandrite laser exposure: Multimodal imaging.

PURPOSE: To report the management of accidental macular photocoagulation during a 750-nm Alexandrite laser hair removal procedure. METHODS: Single case report with images. RESULTS: A 23-year-old girl presented with an immediate visual field defect in her right eye after direct inadvertent exposure to a single discharge from a 750-nm Alexandrite laser used for laser hair removal. Baseline Snellen visual acuity was 20/20 in the involved right eye but the patient reported a subjective visual field defect. She was treated with oral methylprednisolone that was started at a dose of 1 mg/kg/day and then gradually reduced. Six months after the initial exposure, the final visual acuity was 20/20 and there was a significant improvement in the macular lesion. However, the subjective visual field defect continued. She underwent multimodal retinal imaging with optical coherence tomography, fundus fluorescence angiography, and optical coherence tomography angiography in addition to a visual field test and microperimety. CONCLUSION: The present case documents a gradual visual and anatomical improvement following macular photic damage after accidental occupational exposure to a 750-nm Alexandrite laser. The treatment should be arranged according to the localization of the laser damage. Optical coherence tomography angiography also has the potential to help noninvasively detect choriocapillaris damage.

PREFERRED RETINAL LOCUS LOCATIONS IN AGE-RELATED MACULAR DEGENERATION.

PURPOSE: An evaluation of the preferred retinal locus (PRL) in patients with age-related macular degeneration and a central scotoma is becoming a standard of care in the practice of low-vision rehabilitation. This is a retrospective study of PRL specifications and whether they have a correlation with the best-corrected visual acuities of patients with age-related macular degeneration. METHODS: Seventy-two patients with macular degeneration (144 eyes) were included in the study. The PRLs were evaluated monocularly with a scanning laser ophthalmoscope. Each PRL's location, the fovea-PRL distance, the PRL edge of the lesion distance, and PRL stability were measured with the built-in caliper of the ophthalmoscope. RESULTS: The most frequent location of a PRL was nasal (29.2%). The PRL was located in the left visual field of 34.0% of the patients. The best-corrected visual acuity values were positively correlated with the lesion's vertical and horizontal dimensions, as well as its surface area, the PRL-fovea distance, the PRL border of the lesion distance, and PRL stability. CONCLUSION: The clinical PRL evaluation methodology that we describe can be used to facilitate making decisions on how to provide best visual rehabilitation to patients with a central scotoma.