Abstract
Purpose: :
To correlate in patients with late solar retinopathy the morphologic appearance of the macula on optical coherence tomography (OCT) with microperimetry and autofluorescence (AF).
Methods: :
8 patients evaluated at our hospital few days after a solar eclipse in 1999 were invited, 5 years after the exposure, to participate in a ophthalmic evaluation including best corrected visual acuity (VA), biomicroscopy, colour fundus photographs, OCT (Carl Zeiss Meditec), 488 nm AF (HRA II, Heidelberg Eng., Germany), retinal sensitivity and fixation stability with microperimetry system (MP1, Nidek Co, Japan).
Results: :
13 eyes did not show any abnormality on OCT and biomicroscopy evaluation. Visual acuity was 20/20, and AF and microperimetry did not show any pathological fluorescence or reduced retinal sensitivity. The remaining 3 eyes of 3 different patients presented on biomicroscopy a small lamellar defect. OCT confirmed a hyporeflective space at the level of the outer neurosensory retina and retinal pigment epithelium typical of chronic solar rethinopathy. Although visual acuity was 20/20 in 2 eyes and 20/25 in the third eye, the microperimetry showed a decreased retinal sensitivity with a small relative scotoma localized over the foveal area in all the three eyes and AF the presence of a small hypofluorescent spot. There was no difference of fixation stability between the 3 affected eyes and the remaining 15 healthy eyes.
Conclusions: :
OCT remains the gold standard technique to diagnose solar retinopathy because of the presence of the typical lesion. Nevertheless microperimetry appears as a useful technique enabling a more precise quantitative analysis of the retinal function sensitivity than isolated VA testing. The hypofluorescent spot on AF could be consistent with a defect of the retinal pigment epithelium as evidenced by OCT.
Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)