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Yang S, Lei C, Zhang M. Vitrectomy for a traumatic macular hole caused by cosmetic laser in a beauty salon: A case report. Heliyon 2024; 10:e28466. [PMID: 38638955 PMCID: PMC11024555 DOI: 10.1016/j.heliyon.2024.e28466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 03/17/2024] [Accepted: 03/19/2024] [Indexed: 04/20/2024] Open
Abstract
Background The Nd:YAG laser is widely used in various aspects of work and life. Currently, it has become a popular cosmetic technique in beauty salons. The laser can be dangerous when it flashes into people's eyes. Case presentation A 34-year-old female sustained a 1064-nm Q-switched Nd:YAG laser injury to her left eye. One month after the injury, she presented to our clinic with best-corrected visual acuity (BCVA) of 20/250 and a full-thickness macular hole on the optical coherence tomography (OCT). The patient received pars plana vitrectomy, internal limiting membrane peeling and sterile air injection 3 months after the injury. OCT showed closure of the hole 9 days postoperatively. After a 3-month follow-up, her BCVA improved to 20/100. Conclusions This case report comprehensively introduces the whole progression of a cosmetic laser-induced macular hole from formation to recovery. Due to the potential threats of the laser and its irreversible damage to the retina and choroid, sufficient education should be given before performing any laser devices, especially those without professional knowledge.
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Affiliation(s)
- Songyue Yang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Chunyan Lei
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Meixia Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, China
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2
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Flegel L, Kherani F, Richer V. Review of Eye Injuries Associated With Dermatologic Laser Treatment. Dermatol Surg 2022; 48:545-550. [PMID: 35333214 DOI: 10.1097/dss.0000000000003427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The eye is susceptible to damage during dermatologic laser treatments. OBJECTIVE Discuss the anatomy of the eye related to these procedures, the principles of laser-eye interactions, and ocular injuries reported with dermatologic laser treatments. METHODS PubMed and Embase searches were conducted to identify cases of eye injuries associated with dermatologic laser treatments. RESULTS One hundred nineteen cases of eye injury associated with dermatologic laser treatments were identified. Fifty-nine cases targeted the eyelid during resurfacing and caused ectropion, while 60 cases resulted from direct injury of ocular structures. In most of the cases of the latter, improper eye protection was used (44 of 60, 73%). In nearly all these cases, it was the patient who sustained a potentially avoidable ocular injury (52 of 60, 87%). Thirty-one patients had persistent ocular symptoms at follow-up (52%). The most common procedure in this context was laser hair removal of the face (35 of 60, 58%). Most of the cases developed injuries specific for the particular laser based on its wavelength and affinity to target certain ocular chromophores (59 of 60, 98%). CONCLUSION Most of the dermatologic laser-associated eye injury cases have occurred in the context of laser resurfacing or laser hair removal and are potentially preventable.
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Affiliation(s)
- Lisa Flegel
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Femida Kherani
- Department of Ophthalmology, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Surgery, University of Calgary, Calgary, Alberta, Canada
- Heights Laser, Burnaby, British Columbia, Canada
| | - Vincent Richer
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
- Pacific Derm, Vancouver, British Columbia, Canada
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3
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Macular Holes: Main Clinical Presentations, Diagnosis, and Therapies. J Ophthalmol 2022; 2022:2270861. [PMID: 35450323 PMCID: PMC9017549 DOI: 10.1155/2022/2270861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/08/2022] [Accepted: 03/14/2022] [Indexed: 11/25/2022] Open
Abstract
Macular holes are a spectrum of retinal diseases that comprehends full-thickness macular holes (FTMHs), refractory/recurrent macular holes, lamellar macular holes (LMHs), myopic macular holes (MMHs), traumatic macular holes, and macular holes secondary to other retinal pathologies or injuries. There are various classifications of the subtypes of macular hole, and only in recent times researchers defined a common nomenclature, especially thanks to the evolution in retinal imaging, offered by new instruments like the swept-source OCT. The proposed therapies for macular holes are different and range from a “wait-and-see” approach to the vitrectomy, with different results in each subtype of macular hole. This narrative review has the purpose to investigate the available evidence in literature to give a summary of the knowledge about these retinal pathologies.
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Kuwayama S, Kato A, Kuwayama S, Fujii S, Sugitani K, Osada A, Ogura Y, Yasukawa T. A case of Nd:YAG laser-induced traumatic macular hole with good visual prognosis after vitrectomy with inverted internal limiting membrane technique. Am J Ophthalmol Case Rep 2022; 25:101391. [PMID: 35198815 PMCID: PMC8841575 DOI: 10.1016/j.ajoc.2022.101391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 01/26/2022] [Accepted: 01/31/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose To report an accidental case of traumatic macular hole caused by Nd:YAG laser in a dermatology clinic. Observations A 24-year-old woman sustained a laser injury to her right eye while practicing a dermatologic treatment using a Nd:YAG laser without wearing protective goggles. She noticed sudden-onset and progressing visual loss in her right eye and consulted an ophthalmologist 2 days after injury. The best-corrected visual acuity (BCVA) of her right eye decreased to 20/133. Fundus examination showed white parafoveal flecks with a central retinal hemorrhage and underlying serous retinal detachment. The retinal sensitivity in this lesion deteriorated. Two weeks later, a full-thickness macular hole (FTMH) developed in the affected eye. She was referred to Nagoya City University Hospital where the laser damage described was observed. The BCVA was 20/67. She underwent pars plana vitrectomy performed using the inverted internal limiting membrane (ILM) flap technique and gas tamponade. One week postoperatively, the FTMH closed, the BCVA in her right eye improved to 20/50, and the retinal sensitivity in the macular area mostly improved. The BCVA gradually improved and reached 20/25 9 months after the injury. Conclusions and importance Protective goggles must be worn when using an Nd:YAG laser in the laboratory or clinical setting. In the unfortunate event of a FTMH, early vitrectomy with an inverted ILM flap technique can be helpful to achieve a good visual prognosis.
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Affiliation(s)
- Satoshi Kuwayama
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Aki Kato
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
- Corresponding author. Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Soichiro Kuwayama
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Syunsuke Fujii
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Kazuhiko Sugitani
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | | | - Yuichiro Ogura
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Tsutomu Yasukawa
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
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5
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Wang X, Zhang T, Jiang R, Xu G. Vitrectomy for laser-induced full-thickness macular hole. BMC Ophthalmol 2021; 21:135. [PMID: 33714272 PMCID: PMC7956069 DOI: 10.1186/s12886-021-01893-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/01/2021] [Indexed: 12/28/2022] Open
Abstract
Background To report the structure and visual outcomes of pars plana vitrectomy (PPV) for laser-induced full-thickness macular holes (MHs). Methods This retrospective study enrolled 10 patients who underwent vitrectomy for MHs caused by laser injury. Best corrected visual acuity (BCVA), macular spectral-domain optical coherence tomography (OCT) and OCT angiography (OCTA) were used for assessment. Results Four patients were injured by unexpected expose of an yttrium aluminum garnet (YAG) laser, and six patients were accidentally injured by a handheld laser. The MH minimum diameters (MDs) ranged from 55 to 966 μm (mean = 548.00 ± 286.10 μm), and BCVA ranged from 20/400 to 20/50 (mean = logMAR 0.87 ± 0.29) preoperatively. All 10 eyes underwent PPV, internal limiting membrane (ILM) peeling, and gas tamponade. All eyes demonstrated closure of the MH with different degrees of discontinuity of the outer layer of the retina, and four eyes exhibited serious retinal pigment epithelium (RPE) destruction. Postoperative BCVA values were significantly improved (mean = logMAR 0.55 ± 0.33; P = 0.032, t = 2.234). The mean BCVA of the destroyed RPE group was significantly worse than that of the non-destroyed RPE group both before and after surgery (P = 0.019; Wilcoxon signed rank test). Further, OCTA indicated choroidal ischemia in the laser-induced MHs. Conclusion Vitrectomy can be successful in closing laser-induced full-thickness MHs and improving visual acuity. However, If RPE/choroid is involved in laser damage in addition to the outer retinal layer, this may indicate poor visual prognosis.
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Affiliation(s)
- Xin Wang
- Eye Institute and Department of Ophthalmology Vision Sciences, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Ting Zhang
- Eye Institute and Department of Ophthalmology Vision Sciences, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Rui Jiang
- Eye Institute and Department of Ophthalmology Vision Sciences, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
| | - Gezhi Xu
- Eye Institute and Department of Ophthalmology Vision Sciences, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.,NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, 200031, China
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6
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Liu BS, Cui WN, Niu R, Chen Q, Nie ZT, Wei JT, Hu BJ. Refractive outcomes after vitrectomy combined with phacoemulsification of idiopathic macular holes. Int J Ophthalmol 2021; 14:250-254. [PMID: 33614454 DOI: 10.18240/ijo.2021.02.11] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/30/2020] [Indexed: 11/23/2022] Open
Abstract
AIM To report the refractive outcomes after vitrectomy combined with phacoemulsification and intraocular lens (IOL) implantation (phaco-vitrectomy) in idiopathic macular holes (IMH). METHODS A total of 56 eyes with IMH (IMH group) that underwent phaco-vitrectomy and 44 eyes with age-related cataract (ARC group) that underwent cataract surgery were retrospectively reviewed. The best corrective visual acuity (BCVA), predicted refractive error (PRE), actual refractive error (ARE), axial length (AL), were measured in both groups before and 6mo after operation. The power calculation of IOL and the predicted refractive error (PRE) were calculated according to the SRK/T formula. The difference of PRE and ARE between the two groups were compared and analyzed. RESULTS In the IMH group, the diameters of macular holes were 271.73±75.85 µm, the closure rate was 100%. The pre- and post-operative BCVA were 0.80±0.35 and 0.40±0.35 logMAR. The PRE of A-ultrasound and IOL Master in the IMH group was -0.27±0.25 and 0.10±0.66 D. The postoperative mean absolute prediction error (MAE) was observed to be 0.58±0.65 and 0.53±0.37 D in the IOL Master and A-ultrasound (P=0.758). The PRE and ARE of the IMH group were 0.10±0.66 D and -0.19±0.64 D (P=0.102). The PRE and ARE of the ARC group was -0.43±0.95 and -0.31±0.93 D (P=0.383). The difference between PRE and ARE was -0.33±0.81 and 0.09±0.64 D in the IMH and ARC groups (P=0.021). The proportion of myopic shift was 67.9% in the IMH group and 27.3% in the ARC group (P=0.004). CONCLUSION The myopic shift can be observed in patients with IMH after phaco-vitrectomy.
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Affiliation(s)
- Bo-Shi Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Wei-Na Cui
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Rui Niu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Qiong Chen
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Ze-Tong Nie
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Jiao-Ting Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Bo-Jie Hu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
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7
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Chen N, Zheng K. Internal limiting membrane peeling without vitrectomy for laser-induced macular holes in two children. Eur J Ophthalmol 2021; 32:NP41-NP45. [PMID: 33506702 DOI: 10.1177/1120672121990633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To describe a technique of internal limiting membrane (ILM) peeling without vitrectomy for the treatment of laser-induced macular holes in two children. METHODS ILM peeling was performed under the vitreous hyaloid, and the vitreous was retained. Slit lamp and optical coherence tomographic examinations were performed before and after surgery. RESULTS Macular holes were closed with different patterns at different time in the two patients, while visual acuity improved significantly in both of them eventually. CONCLUSION The technique of ILM peeling in the absence of vitrectomy can promote the closure of laser-induced macular holes and minimize the surgical procedure, with few vitrectomy complications in pediatric patients. The closure pattern may vary on account of different injury sources and extents.
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Affiliation(s)
- Nan Chen
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Kunkun Zheng
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
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8
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Kaur R, Koul P. Arc flash macular hole. Eur J Ophthalmol 2020; 32:1120672120976230. [PMID: 33243015 DOI: 10.1177/1120672120976230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Macular holes are common. Lightening, direct electric shock induced and laser beam induced macular holes are though rare. Reporting a case of spark flashlight (Arc Flash) induced macular hole in an electrician, which has never been reported. A 19 year old male electrician by profession presented to our clinic with a history of exposure to a bright flash light from spark of wires while at work that led to decrease of vision in his both eyes. Examination revealed a full thickness macular hole in his right eye and loss of foveal photoreceptors in the left eye. Arc flash light exposure in electricians can lead to macular holes too adding a new entity to the already existing types of macular holes.
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9
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Qi Y, Yu Y, You Q, Wang Z, Wang J, Liu W. Hole diameter ratio for prediction of anatomical outcomes in stage III or IV idiopathic macular holes. BMC Ophthalmol 2020; 20:351. [PMID: 32859171 PMCID: PMC7456388 DOI: 10.1186/s12886-020-01614-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To determine whether preoperative hole diameter ratio (HDR) is a predictive factor for postoperative anatomical outcome for stage III or IV idiopathic macular holes (IMHs). METHODS One-hundred and one eyes with stage III or IV IMH were included in this retrospective case series study. All cases were treated with vitrectomy combined with internal limiting membrane (ILM) peeling and room air tamponade. The macular hole (MH) minimum and maximum diameter was measured on preoperative optical coherence tomography (OCT) images. The HDR was defined as the minimum to maximum diameter ratio. RESULTS Eighty-one eyes (80.2%) got a Type I closure after surgery (group A). Postoperative unclosed MHs were found in 20 eyes (19.8%) (group B). The preoperative minimal diameter (703.6 ± 116.1 μm vs. 597.6 ± 120.1 μm, P < 0.01) and HDR (0.6 ± 0.1 vs. 0.5 ± 0.1, P = 0.01) were both significantly smaller in postoperative closed eyes. The closure rate of IMHs with HDR < 0.6 was significantly higher than those with HDR ≥ 0.6 (90.2% vs. 65.0%P = 0.002) . CONCLUSIONS Preoperative HDR < 0.6 is predictive for a good postoperative anatomical outcome in stage III or IV IMHs.
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Affiliation(s)
- Yue Qi
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab; Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaomminxiang Street, Dongcheng District, Beijing, 100730, China
| | - Yanping Yu
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab; Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaomminxiang Street, Dongcheng District, Beijing, 100730, China
| | - Qisheng You
- Casey Eye Institute, Oregon Health Science University, 515 SW Campus Drive, Portland, OR, 97239, USA
| | - Zengyi Wang
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab; Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaomminxiang Street, Dongcheng District, Beijing, 100730, China
| | - Jing Wang
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab; Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaomminxiang Street, Dongcheng District, Beijing, 100730, China
| | - Wu Liu
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab; Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaomminxiang Street, Dongcheng District, Beijing, 100730, China.
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Abstract
PURPOSE To study the etiology, clinical features, management options, and visual prognosis in various types of atypical macular holes (MHs). METHODS A review of the literature was performed, which focused on the etiopathogenesis of atypical or secondary MHs, their differentiating clinical features, management strategies, and varied clinical outcomes. Idiopathic or age-related, myopic, and traumatic MHs were excluded. RESULTS Atypical or secondary MHs arise out of concurrent ocular pathologies (dystrophy, degeneration, or infections) and laser/surgery. The contributing factors may be similar to those responsible for idiopathic or typical MHs, i.e., tangential or anteroposterior vitreofoveal traction or cystoid degeneration. The management is either observation or treatment of the underlying cause. The prognosis depends on the background pathology, duration of disease, and baseline visual acuity governed by the size of MH and morphologic health of underlying RPE and photoreceptors. The closer the morphology of atypical MH is to that of an idiopathic MH, the better the surgical outcome is. CONCLUSION With the advancements in retinal imaging, atypical MHs are now more frequently recognized. With increasing understanding of the underlying disease processes, and improvement in investigations and surgical treatment, management of atypical MHs may improve in the future.
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11
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Bhavsar KV, Michel Z, Greenwald M, Cunningham ET, Freund KB. Retinal injury from handheld lasers: a review. Surv Ophthalmol 2020; 66:231-260. [PMID: 32628946 DOI: 10.1016/j.survophthal.2020.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/25/2020] [Accepted: 06/29/2020] [Indexed: 11/24/2022]
Abstract
Retinal photic injury induced by handheld lasers is a burgeoning public health concern due to the wider accessibility of high-powered devices. Retinal damage from thermal energy can cause potentially severe and permanent vision loss in children and young adults who are particularly vulnerable because of comorbid behavioral, learning, and psychiatric impairments. Understanding the spectrum of specific clinical and imaging features of such laser injuries aids in prompt and accurate diagnosis. Multimodal retinal imaging is important for the identification of the outer retinal abnormalities that characterize this condition. We reviewed 171 reported cases in the English and non-English language literature published from 1999, when handheld laser injury was first described, to December, 2018. Risk factors, demographic and clinical characteristics, as well as multimodal imaging findings, were collected and summarized. These findings both provide insights for public health awareness and guide areas of future investigation.
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Affiliation(s)
- Kavita V Bhavsar
- Casey Eye Institute, Oregon Health & Science` University, Portland, OR, USA; Portland VA Healthcare System, Portland, OR, USA.
| | - Zachary Michel
- Casey Eye Institute, Oregon Health & Science` University, Portland, OR, USA
| | - Miles Greenwald
- Casey Eye Institute, Oregon Health & Science` University, Portland, OR, USA
| | - Emmett T Cunningham
- The Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA, USA; The Department of Ophthalmology, Stanford University School of Medicine, San Francisco, CA, USA; The Francis I. Proctor Foundation, UCSF School of Medicine, San Francisco, CA, USA; West Coast Retina Medical Group, San Francisco, CA, USA
| | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, NY, USA; LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, NY, USA; Department of Ophthalmology, New York University Langone Medical Center, New York, NY, USA; Department of Ophthalmology, Columbia University, New York, NY, USA
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12
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Fan Y, Ma Q, Xin S, Peng R, Kang H. Quantitative and Qualitative Evaluation of Supercontinuum Laser‐Induced Cutaneous Thermal Injuries and Their Repair With OCT Images. Lasers Surg Med 2020. [DOI: 10.1002/lsm.23287] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Yingwei Fan
- Beijing Institute of Radiation Medicine Beijing 100850 China
| | - Qiong Ma
- Beijing Institute of Radiation Medicine Beijing 100850 China
| | - Shenghai Xin
- Department of Biomedical Engineering School of Medicine, Tsinghua University Beijing 100084 China
| | - Ruiyun Peng
- Beijing Institute of Radiation Medicine Beijing 100850 China
| | - Hongxiang Kang
- Beijing Institute of Radiation Medicine Beijing 100850 China
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13
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Tran K, Wang D, Scharf J, Sadda S, Sarraf D. Inner choroidal ischaemia and CNV due to handheld laser-induced maculopathy: a case report and review. Eye (Lond) 2020; 34:1958-1965. [PMID: 32203244 DOI: 10.1038/s41433-020-0830-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 12/18/2019] [Indexed: 12/28/2022] Open
Abstract
There has been a sharp rise of reported handheld laser-induced maculopathy (HLIM) cases over the past decade, a concerning trend that may continue due to unregulated online access to high power lasers. Though HLIM has distinct clinical features, not uncommonly it may masquerade as other retinal disorders. It is critical therefore to recognise the clinical and multimodal imaging characteristics of this important and potentially devastating condition. As HLIM patients are typically young, unique issues need to be considered, such as delayed presentation, difficult history, poor compliance and behavioural or psychiatric comorbidity. This article will review the clinical and diagnostic features of laser injury, with a special emphasis on the multimodal retinal findings. In addition, we present a unique case of HLIM, resembling the presentation of a placoid disease variant and illustrating choroidal ischaemia using advanced retinal imaging, that offers further insight into the mechanisms of laser injury and its complications. The issues addressed in this review aim to increase recognition of an increasingly important and trending condition with potentially profound visual complications.
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Affiliation(s)
- Khoi Tran
- Department of Ophthalmology, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - Derrick Wang
- Department of Ophthalmology, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - Jackson Scharf
- Department of Ophthalmology, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - SriniVas Sadda
- Department of Ophthalmology, Doheny Eye Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - David Sarraf
- Department of Ophthalmology, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, USA. .,Greater Los Angeles VA Healthcare Center, Los Angeles, CA, USA.
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14
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Yang YH, Chung YT, Kim BK, Moon JH, Mun SJ. Inverted internal limiting membrane flap technique and an autologous platelet concentrate to treat an Nd: YAG laser-induced macular hole: A case report. Medicine (Baltimore) 2019; 98:e18185. [PMID: 31764860 PMCID: PMC6882603 DOI: 10.1097/md.0000000000018185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
RATIONALE Nd:YAG laser-induced macular holes (MHs) feature more extensive anatomical defects and worse functional outcomes than idiopathic MHs. Although new treatment options for large refractory MHs have been suggested, the current literature on Nd:YAG laser-induced MHs suggests only conventional pars plana vitrectomy combined with internal limiting membrane (ILM) peeling, which is the same treatment as for idiopathic MHs. PATIENT CONCERNS A 40-year-old dermatologist was referred to us because of a sudden decrease in visual acuity following exposure to a floor-tile-reflected single-shot Nd:YAG laser beam while not wearing protective goggles. DIAGNOSES An Nd:YAG laser-induced MH was diagnosed based on fundoscopy and optical coherence tomography (OCT). INTERVENTIONS Pars plana vitrectomy using an inverted ILM flap technique and autologous platelet concentrate (APC) was performed. OUTCOMES Postoperative spectral domain OCT and en-face OCT showed "U-shaped" closure of the MH and a decreased ellipsoid zone defect, while the best-corrected visual acuity improved from 20/500 to 20/25. LESSONS The inverted ILM flap technique combined with APC is an effective option to achieve successful MH closure and visual improvement in patients with an Nd:YAG laser-induced MH.
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Kim RY, Ra H. Observation of changes after peripheral retinal injury by cosmetic laser, using wide-field scanning laser ophthalmoscope: A case report. Medicine (Baltimore) 2019; 98:e14354. [PMID: 30732166 PMCID: PMC6380843 DOI: 10.1097/md.0000000000014354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Increases in cosmetic laser use have led to recent reports of accidental retinal injuries, most of which are limited to the posterior pole. We report a case of peripheral retinal injury caused by a 1064-nm Nd:YAG: neodymium-doped yttrium aluminum garnet. PATIENT CONCERNS A 27-year-old Asian woman was admitted with scotoma symptoms in her right eye. The patient was a skin care technician. Three days before admission, a laser beam had struck her eye while she was preparing for a laser procedure. DIAGNOSIS During fundus examination, a subretinal hemorrhage with disc diameter (DD) of 4.0 and a preretinal hemorrhage of 2.5 DD in its center were found in the 2 o'clock position of the peripheral retina in the right eye. INTERVENTIONS We monitored the injury for > 6 months, first using fluorescein angiography, then wide-field scanning laser ophthalmoscopy and optical coherence tomography. Oral steroids and vitamins were administered. OUTCOMES During the 6-month follow-up period, blood from the initial sub- and preretinal hemorrhage, as well as vitreous hemorrhage, were all absorbed. Retinal detachment was not observed as scar formation and adhesions had occurred. No interventions were considered necessary. LESSONS When treating a patient who has experienced laser eye injury, the possibility of peripheral retinal injury should be considered. Peripheral retinal injury caused by 1064-nm Nd:YAG: neodymium-doped yttrium aluminum garnet has a relatively good prognosis, suggesting that it will not progress to retinal detachment.
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Commiskey PW, Heisel CJ, Paulus YM. Non-Therapeutic Laser Retinal Injury. INTERNATIONAL JOURNAL OF OPHTHALMIC RESEARCH 2019; 5:321-335. [PMID: 32923732 PMCID: PMC7486027 DOI: 10.17554/j.issn.2409-5680.2019.05.90] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND: As lasers have become an increasingly important component of commercial, industrial, military, and medical applications, reported incidents of non-therapeutic laser eye injuries have increased. The retina is particularly vulnerable due to the focusing power and optical transparency of the eye. Continued innovations in laser technology will likely mean that lasers will play an increasingly important and ubiquitous role throughout the world. Critical evaluation should thus be paid to ensure that non-therapeutic injuries are minimized, recognized, and treated appropriately. METHODS: A comprehensive literature review on the PubMed database was conducted to present case reports and case series representative of the variety of laser eye injuries in different injury circumstances, tissue types, and biological damage mechanisms. RESULTS: A general summary of non-therapeutic laser retina injuries is presented, including information about growth of the industry, increasingly accessible online markets, inconsistent international regulation, laser classifications, laser wavelengths, and laser power, mechanisms of tissue injury, and a demonstration of the variety of settings in which injury may occur. Finally, 68 cases found in the literature are summarized to illustrate the presentations and outcomes of these patients. CONCLUSIONS: As non-therapeutic laser eye injuries increase in frequency, there is a greater need for public health, policy, diagnosis, and treatment of these types of injuries.
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Affiliation(s)
- Patrick W Commiskey
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, the United State
| | - Curtis J Heisel
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, the United State
| | - Yannis M Paulus
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, the United State.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, the United State
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González Martín-Moro J, Hernández Verdejo JL, Zarallo Gallardo J. Photic maculopathy: A review of the literature (ii). ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2018; 93:542-550. [PMID: 30122550 DOI: 10.1016/j.oftal.2018.06.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 06/22/2018] [Accepted: 06/26/2018] [Indexed: 06/08/2023]
Abstract
The human retina, as transducer of light energy, is especially exposed to light toxicity. Solar maculopathy has been the only form of photic maculopathy for millennia, often secondary to the observation of an eclipse. During the last century, technological advances have led to the appearance of new forms of photic maculopathy, related to the exposure to new forms of artificial light, such as welding devices and lasers. In recent years the general use of laser pointers has led to an upturn in interest in this pathology. The aim of this review is to offer an integrated view of the different types of photic maculopathy. Due to the extension of the topic, the review is presented divided into 2 parts. In this second part, atomic bomb maculopathy, laser maculopathy, iatrogenic forms of photic maculopathy, and foveomacular retinitis are presented.
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Affiliation(s)
- J González Martín-Moro
- Servicio de Oftalmología, Hospital Universitario del Henares, Coslada, Madrid, España; Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, España.
| | | | - J Zarallo Gallardo
- Servicio de Oftalmología, Hospital Universitario del Henares, Coslada, Madrid, España; Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, España
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