Significance
This case report demonstrates the use of novel imaging techniques and functional tests to longitudinally evaluate retinal structure and function following laser retinal injury. The structural and functional prognosis could be predicted with clinical findings, high-resolution retinal imaging, and functional testing.
Purpose
We present a laser retinal injury case in which an adaptive optics scanning laser ophthalmoscope and adaptive-optics-based psychophysics were used to examine and monitor the retinal structure and function after accidental exposure to a 1-watt infrared laser beam.
Case Report
A 23-year-old patient was unwittingly exposed to a 1-watt, 852 nm continuous-wave laser at work as they noticed a small central blurry spot in the right eye. An initial eye examination was done one-day post exposure and the right eye’s acuity was 20/25-2. Posterior segment evaluation revealed disrupted outer retina near right eye’s fovea. Adaptive optics imaging 2 weeks after the exposure revealed a 0.50x0.75-degree elliptical area with irregular borders and abnormal cone reflectivity just below the fovea. Starting one-month follow-up, structural recovery was observed on optical coherence tomography (OCT). Subsequent adaptive optics imaging showed significant recovery of cone reflectivity. Importantly, adaptive optics microperimetry showed measurable detection thresholds at all affected retinal locations at 6 months, which restored normal sensitivity at 10 months.
Conclusions
Retinal structure and function from laser injury can be visualized and measured with OCT, adaptive optics imaging and psychophysics. An intact Bruch’s membrane on OCT and measurable retinal sensitivity by adaptive optics microperimetry may serve as good biomarkers for retinal recovery.
