High-Resolution Optical Coherence Tomography Findings in Solar Maculopathy and the Differential Diagnosis of Outer Retinal Holes

Massachusetts Eye & Ear Infirmary, Boston, MA 02114, USA.
American Journal of Ophthalmology (Impact Factor: 3.87). 06/2011; 152(3):413-419.e6. DOI: 10.1016/j.ajo.2011.02.012
Source: PubMed

ABSTRACT To characterize the morphology of outer retinal holes caused by solar maculopathy, using spectral-domain optical coherence tomography (SD-OCT).
This study is an observational case series.
The SD-OCT findings of 3 patients (6 eyes) with chronic solar maculopathy are presented.
SD-OCT demonstrates a characteristic appearance of partial-thickness hole(s) in the outer retina at the fovea. In 3 of 6 eyes, there is 1 hole directly beneath the umbo. In the remaining 3 eyes, there are multifocal holes spread across the fovea. Holes in more restricted layers, as had been previously reported with time-domain OCT, were not seen. In addition, advanced visualization of SD-OCT data demonstrates a hyperreflective ring around the outer retinal hole.
SD-OCT can be used diagnose solar maculopathy. In patients with central scotomas, characteristic outer retinal hole(s) without inner retinal cystic changes may prompt the clinician to uncover an undisclosed history of sungazing. Similar OCT findings can be caused by welder's maculopathy, tamoxifen retinopathy, juxtafoveal macular telangiectasia, foveolar vitreomacular traction, or, rarely, a closed macular hole, achromatopsia, alkyl nitrite abuse, acute retinal pigment epitheliitis, or Stargardt disease.

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    • "International Journal of Diagnostic Imaging, 2014, Vol.1, No. 1 ISSN 2331-5857 E-ISSN 2331-5865 30 complex [3] [4] "
    02/2014; 1(1). DOI:10.5430/ijdi.v1n1p28
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    • "Spectral-domain optical coherence tomography (SD- OCT) is a noninvasive imaging technique that is useful for the detection of foveal impairment and to outline the location and extension of retinal injury from acute solar retinopathy [2]. However, acute solar retinopathy can sometimes share biomicroscopic and SD-OCT foveal findings with pathologies such as whiplash injury, sunbed exposure, ocular trauma, the initial stages of an idiopathic macular hole, persistent retinal defects following successful macular hole repair, idiopathic parafoveal telangiectasis, and solitary macular cysts [3] [4]. Differential diagnosis is often handled according to patient history combined with OCT findings. "
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    ABSTRACT: . Solar retinopathy is a rare clinical disturbance, for which spectral-domain optical coherence tomography (SD-OCT) findings are not always consistent. We report on two cases of solar retinopathy and discuss its differential diagnosis. . This is an observational case study. . A 12-year-old female was referred to ophthalmology for bilateral scotoma. Visual acuity was 20/50 in both eyes. Fundus examination was unremarkable, except for slight yellowish material in the central macula, bilaterally. SD-OCT revealed juxtafoveal microcystic cavities in the outer retina, interruption of the external limiting membrane and the inner and outer segment junctions, with disorganized material in the vitelliform space. Fundus autofluorescence showed hypoautofluorescence surrounded by a relatively hyperautofluorescent ring, bilaterally. Similar clinical and morphological findings were detected in a 27-year-old male. . Solar retinopathy has a subtle presentation and patients often deny sun-gazing. SD-OCT and fundus autofluorescence are noninvasive and useful tools for its diagnosis.
    02/2013; 2013:906920. DOI:10.1155/2013/906920
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    • "Solar retinopathy was first described using time domain OCT by Bechmann and colleagues where they found a hyper-reflective area at the fovea and all retinal layers were affected [12]. Several studies using earlier modalities of OCT have shown transient increase in foveal reflectivity [12], reduced reflectivity from the retinal pigment epithelium [3,7-11] or disruption of the inner segment and outer segment of the photoreceptor layers [8-11,13-20]; but each case series demonstrated that OCT retinal structural alterations may not be consistent in every case of solar retinopathy [2-4,7-20]. Acute changes seen on OCT from solar retinopathy have been described to affect predominantly the outer photoreceptor segments and may even resolve with time [3,4]. "
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    ABSTRACT: 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. 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. 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. 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.
    The Open Ophthalmology Journal 06/2012; 6:29-35. DOI:10.2174/1874364101206010029
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