Incidence and long-term outcome of laser pointer maculopathy in children

Abstract

Purpose: Single center study to evaluate the incidence and long-term outcome of laser pointer maculopathy (LPM).

Methods: Medical records of 909,150 patients visiting our institution between 2007 and 2020 were screened in our electronic patient record system using the keywords "laserpointer," "laser pointer," and "solar."

Results: Eight patients (6/2 male/female, 11 eyes) with a history of LPM were identified by fundoscopy and optical coherence tomography (OCT), all of whom were children (6/2 male/female). Mean age at injury was 12.1 years (range 6-16). Five children (62.5%) were injured between 2019 and 2020, three (37.5%) between 2007 and 2018. Median best-corrected visual acuity (BCVA) of affected eyes at first presentation was 20/25 (range 20/50-20/16). Follow-up examination was performed in seven children (10 eyes) with a median follow-up period of 18 months (range 0.5-96). BCVA improved in 4 children (5 eyes; BCVA at follow-up 20/22.5, range 20/40-20/16). Three of these four children were treated with oral steroids. OCT revealed acute signs such as intraretinal fluid to resolve quickly, while outer retinal disruption persisted until the last follow-up in eight of eleven eyes. These lesions resembled lesions of patients with solar retinopathy of which seven cases (11 eyes) were identified between 2007 and 2020.

Conclusion: Readily available consumer laser pointers can damage the retina and the underlying retinal pigment epithelium, possibly leading to long-lasting visual impairments. The number of laser pointer injuries has increased over the last years. Therefore, access to laser pointers for children should be strictly controlled.

Keywords: Children; Laser injury; Laser pointer; Retinal damage; Solar retinopathy.

Fig. 1

Temporal distribution of laser pointer maculopathy cases in the eye center of the university Freiburg, Germany, from 2007 to 2020. Temporal distribution of cases with suspected laser injury from laser pointers (dashed line, triangles) and cases with confirmed laser injury from laser pointers (solid line, circles)

Fig. 2

Fundoscopy and macular OCT of LPM lesions at initial presentation. Macular OCT images and fundus photography of the macula of patients with confirmed laser pointer injury. Affected eyes are marked with red borders. OD = ocular dexter, OS = ocular sinister, N.A. = not available

Fig. 3

Time course of LPM lesions in macular OCT. Time after injury is indicated at the top of each image. BCVA at the respective time is given on the right of the image