Macarez R, Vanimschoot M, Ocamica P, Kovalski J-L
Service d'Ophtalmologie, HIA Clermont-Tonnerre, Brest.
J Fr Ophtalmol. 2007 Mar;30(3):276-80. doi: 10.1016/s0181-5512(07)89590-8.
Solar maculopathy is caused by sun-gazing without protection and in most cases appears to be reversible. Retinal damage may be caused by photochemical changes combined with a rise in temperature at the time of sun observation. We report a case of bilateral solar retinopathy following direct sun gazing after observation of the partial eclipse on 3 October 2005. A 25-year-old Caucasian man presented 24 h after watching the eclipse with symptoms of blurred vision and a bright positive central scotoma. Total direct viewing time was approximately 5 min. While observing the eclipse, the patient kept both eyes open. On presentation, his visual acuity was 20/25 in his right eye and 20/32 in his left eye. Ophthalmoscopic examination revealed a bilateral yellowish-white spot in the center of the foveal region. Static visual field examination did not disclose any absolute scotoma but a decrease in the foveal threshold was noted in both eyes. Optical coherence tomography (OCT) examination revealed a bilateral increased reflectivity of the inner foveal retina that was greater in the left eye. This finding was associated with a hyporeflective area of the underlying retinal pigment epithelium: choriocapillaris complex and an increase in retinal thickness. Eight days later, visual acuity was 20/20 in each eye. Funduscopy showed the yellow lesion had vanished. Four months after exposure, funduscopy was normal and OCT scan showed normal reflectivity of all retinal layers in the fovea. However, static visual field examination disclosed a decreased foveal threshold on the left eye. We compare the OCT findings in this patient with the data reported in the literature. Indeed, various OCT findings have been reported depending on the intensity and frequency of sun exposure. This observation demonstrates that OCT appears to be potentially useful in the evolutive follow-up of solar maculopathy, and emphasizes the importance of eye safety during solar eclipse observation.
日光性黄斑病变是由于在无防护的情况下直视太阳引起的，在大多数情况下似乎是可逆的。视网膜损伤可能是由光化学变化以及观察太阳时温度升高共同导致的。我们报告一例2005年10月3日观察日偏食后因直接直视太阳导致的双侧日光性视网膜病变病例。一名25岁的白种男性在观看日偏食24小时后出现视力模糊和中央明亮阳性暗点的症状。总的直接观看时间约为5分钟。观察日偏食时，患者双眼睁开。就诊时，其右眼视力为20/25，左眼视力为20/32。眼底检查发现双侧黄斑区中心有黄白色斑点。静态视野检查未发现任何绝对暗点，但双眼黄斑阈值均降低。光学相干断层扫描（OCT）检查显示双侧黄斑内层视网膜反射率增加，左眼更为明显。这一发现与下方视网膜色素上皮-脉络膜毛细血管复合体的低反射区以及视网膜厚度增加有关。八天后，双眼视力均为20/20。眼底检查显示黄色病变已消失。暴露四个月后，眼底检查正常，OCT扫描显示黄斑区所有视网膜层反射率正常。然而，静态视野检查显示左眼黄斑阈值降低。我们将该患者的OCT检查结果与文献报道的数据进行了比较。事实上，根据太阳暴露的强度和频率，已报道了各种OCT检查结果。该观察结果表明，OCT在日光性黄斑病变的演变随访中似乎具有潜在用途，并强调了日偏食观察期间眼部安全的重要性。
