Zheng Xinhua, Xie Ping, Hu Zizhong, Zhang Weiwei, Liang Kang, Wang Xiuying, Liu Qinghuai
Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Medicine (Baltimore). 2017 Jan;96(3):e5830. doi: 10.1097/MD.0000000000005830.
A large proportion of the output of quartz infrared heat lamps is emitted as infrared radiation (IR). Retinal damage induced by IR-A and visible light on arc welders has been reported. However, case reports of retinal damage caused by quartz infrared heat lamps are rare. To the best of our knowledge, this is the first reported case of phototoxic maculopathy induced by quartz infrared heat lamps.
We report a female with a 1-month history of progressive blurred vision and dysmorphopsia in her right eye after improper staring at the tubes of a quartz infrared heater. Her best corrected visual acuity of the right eye was 20/32. Optical coherence tomography revealed a defect from the ellipsoid zone to retinal pigment epithelium (RPE)/Bruch's complex layer with a diameter of 360mmat its widest. P1 amplitudes in the two central concentric rings were reduced as assessed by multifocal electroretinography.
The patient was diagnosed with phototoxic maculopathy.
The patient was advised to cease all exposure to the infrared heater and was treated with peribulbar injections of methylprednisolone, oral Pancreatic Kininogenase, and oral Mecobalamin.
Ten months later, her BCVA improved to 20/20. All examination results returned to normal except for a small residual defect in the interdigitation zone and RPE/Bruch's complex layer in her optical coherence tomography.
Light emitted by quartz infrared heat lamps may cause damage to the retina through photothermal and photochemical means. The public is insufficiently aware of the hazard potential of infrared heat lamps and other IR-A sources on human retina.
石英红外加热灯的大部分输出以红外辐射（IR）的形式发射。已有报道称，IR-A和可见光会对电焊工的视网膜造成损伤。然而，关于石英红外加热灯导致视网膜损伤的病例报告却很罕见。据我们所知，这是首例由石英红外加热灯引起的光毒性黄斑病变的报告。
我们报告了一名女性，在不当注视石英红外加热器的灯管后，右眼出现了1个月的渐进性视力模糊和视物变形史。她右眼的最佳矫正视力为20/32。光学相干断层扫描显示，从椭圆体带至视网膜色素上皮（RPE）/布鲁赫复合体层存在一个缺损，其最宽处直径为360mm。通过多焦视网膜电图评估，两个中央同心环的P1振幅降低。
该患者被诊断为光毒性黄斑病变。
建议患者停止所有与红外加热器的接触，并接受球周注射甲基泼尼松龙、口服胰激肽原酶和口服甲钴胺治疗。
10个月后，她的最佳矫正视力提高到了20/20。除了光学相干断层扫描显示在指状交叉区和RPE/布鲁赫复合体层有一个小的残余缺损外，所有检查结果均恢复正常。
石英红外加热灯发出 的光可能通过光热和光化学方式对视网膜造成损伤。公众对红外加热灯和其他IR-A源对人类视网膜的潜在危害认识不足。
