High definition spectral domain optical coherence tomography findings in three patients with solar retinopathy and review of the literature

Abstract

Purpose: To describe ocular findings in 3 cases of solar retinopathy using high definition, spectral domain optical coherence tomography (SD-OCT) and review the literature for optical coherence tomography (OCT) characteristics associated with worse vision.

Methods: Case series and retrospective review of clinical features and Spectralis SD-OCT (Heidelberg Engineering, Vista, California, United States of America). A literature review of OCT findings in cases of solar retinopathy reported on MEDLINE was also performed and analyzed.

Results: Six eyes of 3 patients with solar retinopathy revealed significant foveal pathology. Visual acuity ranged from Snellen 20/30 to 20/50. High definition SD-OCT demonstrated defects at the level of the inner and outer segment junction of the photoreceptors as well as in the inner high reflective layer. There was a significant correlation between chronic disruption of the inner photoreceptor junction with worse vision based on the current case series and literature review.

Conclusions: Screening patients with exposure to central foveal damage from solar retinopathy with high definition SD-OCT improves diagnosis and assessment of photoreceptor damage and vision loss.

Keywords: Solar retinopathy; Spectralis SD-OCT.; fovea; spectral domain optical coherence tomography.

Fig. (1)

Case 1: (A) Right eye macula autofluorescence Optical Coherence Tomography (OCT) image and (B) left eye macula autofluorescence OCT image showing no autofluorescent abnormalities. (C) OCT through the right eye fovea showing defects in the inner segment, outer segment and inner high reflective layers. The external limiting membrane is hyperreflective anterior to the foveal defect. (D) OCT through the left eye fovea showing similar defects in the inner segment, outer segment, and inner high reflective layers.

Fig. (2)

Case 2: (A) Right eye macula autofluorescence OCT image showing no autofluorescent abnormalities. (B) Left eye macula autofluorescence OCT image with hyperfluorescence parafoveally. (C) OCT through the right eye fovea showing defects in the inner segment, outer segment, and inner high reflective layers. Mild hyperreflectivity is noted in the external limiting membrane anterior to the lesion. (D) OCT through the left eye fovea shows a pigment epithelial detachment parafoveally with no subretinal fluid and disruption of the inner high reflective layer and the inner and outer segment junction.

Fig. (3)

Case 3: (A) Right eye macula red-free OCT image and (B) left eye macula red-free OCT image showing a brighter foveal area. (C) OCT through the right eye fovea showing lesions in the inner segment, outer segment, and inner high reflective layers. Note the hyperreflective external limiting membrane anterior to the lesion. (D) OCT through the left eye fovea showing disruption in the inner segment, outer segment, and inner high reflective layers.