ABSTRACT
PURPOSE: To describe the first case of a combined sub-hyaloid and sub-internal limiting membrane macular hemorrhage after recreational laser exposure. METHODS: A 23-year-old patient presented with an acute loss of vision in his right eye (OD) immediately after a brief exposure to a laser beam at a music festival. Color photography, spectral-domain optical coherence tomography (SD-OCT), and multifocal electroretinogram (mfERG) were performed for diagnosis and follow-up. RESULTS: On presentation, visual acuity was 20/400 in the OD and 20/20 in the left eye. Posterior segment examination of his OD revealed a preretinal hemorrhage at the macula. SD-OCT images exposed a combined sub-hyaloid and sub-internal limiting membrane localization. Successful VPP with ILM peeling was carried out. Although sequential mfERG displayed almost complete restoration of the P1 amplitude 6 months posterior to VPP, SD-OCT demonstrated permanent damage to outer retinal layers. Final BCVA on OD was 20/30. CONCLUSION: The expanding and unregulated use of lasers in everyday life has created an increasing amount of cases of laser-induced retinopathy in recent years. Much more attention should be addressed in laser safety and awareness to prevent future ocular injuries. In acute phases of sub-hyaloid hemorrhages blocking direct visualization of the posterior pole, mfERG is a valuable tool to address initial macular pathology.
Subject(s)
Eye Injuries/etiology , Lasers/adverse effects , Retina/injuries , Retinal Hemorrhage/etiology , Vitreous Body/injuries , Vitreous Hemorrhage/etiology , Electroretinography , Eye Injuries/diagnostic imaging , Eye Injuries/surgery , Holidays , Humans , Male , Retinal Hemorrhage/diagnostic imaging , Retinal Hemorrhage/surgery , Tomography, Optical Coherence , Visual Acuity/physiology , Vitrectomy , Vitreous Hemorrhage/diagnostic imaging , Vitreous Hemorrhage/surgery , Young AdultABSTRACT
BACKGROUND: Optical coherence tomography is a useful tool in several diseases. Its intraoperative use with the intention of improving anatomical results has recently been described. PURPOSE: To determine the usefulness and safety of optical coherence tomography during pars plana vitrectomy for several vitreo-retinal diseases. MATERIAL AND METHODS: A prospective case series is reported, in which the decision that influenced the use of the optical coherence tomography imaging during pars plana vitrectomy is evaluated. A RESCAN 700 microscope that includes a spectral domain tomography was used to obtain the images. At the end of each procedure the surgeons completed a questionnaire to determine if the tomographic image had an influence when making decisions during the surgery, or change the decision during the procedure. RESULTS: Thirteen patients with pars plana vitrectomy were included, with cataract surgery also performed in 6 patients. The surgeon considered that the intraoperative image influenced the decision during the procedure in 8 cases. CONCLUSION: Intraoperative optical coherence tomography is helpful for a safe patient diagnosis. It does not affect the surgery time, and in some cases it is useful for optimising the procedure in vitreous-retinal surgery.
