High-speed ultrahigh-resolution optical coherence tomography findings in chronic solar retinopathy

Abstract

Purpose: To describe ocular findings for a 34-year-old man with chronic solar retinopathy using high-speed ultrahigh-resolution (UHR) optical coherence tomography (OCT).

Methods: Fundus photography, fluorescein angiography, and Stratus OCT (Carl Zeiss Meditec, Inc., Dublin, CA) were performed. A high-speed UHR OCT prototype developed in our ophthalmology clinic was used to obtain detailed images of the retina.

Patients: Two eyes of one patient with chronic solar retinopathy were studied.

Results: Both Stratus OCT and high-speed UHR OCT demonstrated foveal thinning bilaterally. In addition, high-speed UHR OCT showed distinct hyporeflective disruptions in the photoreceptor inner segment/outer segment junction and photoreceptor outer segments bilaterally. En face OCT images from three-dimensional OCT data sets revealed hyporeflective regions of photoreceptor atrophy in the outer retina.

Conclusions: High-speed UHR OCT showed more detail than standard OCT, and findings were consistent with histopathologic and ultrastructural features that have been reported previously. Solar retinopathy should be studied further with high-speed UHR OCT to determine the short- and long-term effects of solar radiation damage.

Fig. 1

A, Color photograph of the right eye. A well demarcated circular lesion is present in the fovea (yellow arrow). B, Horizontal standard 10-μm-resolution (Stratus OCT [optical coherence tomography]) OCT image of the right eye. The foveal thickness (central 1-mm-diameter ring) is 143 μm. C, Horizontal high-speed ultrahigh-resolution (UHR) OCT image of the right eye with 3.5-μm axial resolution and 8,192 axial scans. Early posterior hyaloid separation is visible (white arrow). The outer nuclear layer is significantly thinned and is almost entirely absent centrally. ONL, outer nuclear layer; IS/OS, photoreceptor inner segment/outer segment junction; ELM, external limiting membrane; RPE, retinal pigment epithelium. D, Two times magnification of the high-speed UHR OCT image. Vertical hyporeflective bands disrupting the IS/OS junction and photoreceptor outer segments (PR OS) are clearly visible, interspersed with areas of normal reflectivity.

Fig. 2

En face images of the reflectivity of the outer retina show a similar pattern of hyporeflectivity in both eyes where the photoreceptors are disrupted (yellow outline). The area of involvement is greater in the right eye.