Zhang Lijuan, Zheng Andrew, Nie Hongping, Bhavsar Kavita V, Xu Yu, Sliney David H, Trokel Stephen L, Tsang Stephen H
a Department of Ophthalmology , Edward S. Harkness Eye Institute of Columbia University , New York , NY , USA .
b Shanxi Eye Hospital, Shanxi Medical University , Taiyuan , China .
Ophthalmic Genet. 2016;37(1):59-67. doi: 10.3109/13816810.2015.1059458.
To describe the phenotypes associated with laser-induced retinal damage in children.
Five patients with maculopathy and reduced visual acuity associated with laser pointer use were evaluated. Best-corrected visual acuity, retinal structure, and function were monitored with color fundus, infrared (IR), and red-free images, fundus autofluorescence (AF), spectral domain-optical coherence tomography (SD-OCT), and full-field electroretinography (ERG).
All five laser pointer injury patients had retinal lesions resembling a macular dystrophy (one bilateral and four unilateral). These lesions were irregular in shape but all had a characteristic dendritic appearance with linear streaks radiating from the lesion. Photoreceptor damage was present in all patients, but serial OCT monitoring showed that subsequent photoreceptor recovery occurred over time in the eyes of at least four patients. One patient also had bilateral pigment epithelial detachments (PED). Both hyper- and hypoautofluorecence were observed in the laser damage area.
In general, OCT and IR images are quite useful to diagnose laser damage, but AF is not as sensitive. Laser pointer damage in children can occasionally be misdiagnosed as a macular dystrophy disease, but the distinctive lesions and OCT features are helpful for differentiating laser damage from other conditions.
描述与儿童激光诱导视网膜损伤相关的表型。
对5例因使用激光笔而导致黄斑病变和视力下降的患者进行评估。通过彩色眼底、红外（IR）、无赤光图像、眼底自发荧光（AF）、光谱域光学相干断层扫描（SD-OCT）和全视野视网膜电图（ERG）监测最佳矫正视力、视网膜结构和功能。
所有5例激光笔损伤患者均有类似黄斑营养不良的视网膜病变（1例双侧，4例单侧）。这些病变形状不规则，但均具有特征性的树枝状外观，有线状条纹从病变处放射状分布。所有患者均存在光感受器损伤，但连续的OCT监测显示，至少4例患者眼中的光感受器随后随时间恢复。1例患者还出现双侧色素上皮脱离（PED）。在激光损伤区域观察到高自发荧光和低自发荧光。
一般来说，OCT和IR图像对诊断激光损伤非常有用，但AF不那么敏感。儿童激光笔损伤偶尔会被误诊为黄斑营养不良疾病，但独特的病变和OCT特征有助于将激光损伤与其他疾病区分开来。
