Case #53 – Laser Pointer Maculopathy

Case 1: Optovue Retina Map OD This Inferior horizontal scan below the fovea OD appears also to be Intact.

Case 1: Optovue Retina Map OD Slightly below the fovea OD, the PIL appears normal.

Case 1: Optovue Retina Map OD This horizontal scan OD very near to the fovea reveals arc like reflections which perhaps are opacities in Henle’s fiber layer.

Case 1: Optomap® OS This horizontal scan slightly above the fovea OD reveals disruption of the PIL and the Inner RPE Border (IRB- formally often termed Verhoeff membrane.) The hyporeflective space in the fovea is cyst-like but not round.

Case 1: Optovue Retina Map OD This superior horizontal OCT is closer to the fovea but still normal OD.

Histological Section as Compared to the OCT Image  Although the photoreceptor integrity line, or the PIL (defined as the junction between the inner and outer segments) is barely visible in most histological sections, it is highly prominent in normal SD OCTs. The PIL, as shown above, should be continuous throughout the entire scan in

Case 1: Optovue Retina Map OD Additional iVue images were obtained, here with the Retina Map program. Note that the section above the macula in the OD is normal and the PIL is intact.

Case 1: Optomap® plus with Resmax™ OD and OS KEY:Color OptomapAuto FluorescenceA DFE revealed the same findings as the color Resmax images. However, direct and indirect ophthalmoscopy do not reveal AF abnormalities, demonstrated here in the OS only.

A refraction yielded -1.50 spheres in each eye with VA of 20/25+ OD and 20/40+ OS. The right eye with better VA demonstrates normal AF in the macula but the left eye with more reduced VA clearly demonstrates zones of hyper AF.

Case 1: Optomap® plus with Resmax™ OU Although the CD appears somewhat larger in the OD than OS, glaucoma is still an unlikely etiology in this case. The cilio-retinal artery OD is unrelated to the patient’s symptoms.