Department of Ophthalmology, Stein Eye Institute, University of California Los Angeles, Los Angeles, CA, USA.
Department of Ophthalmology, Doheny Eye Institute, University of California Los Angeles, Los Angeles, CA, USA.
Eye (Lond). 2020 Nov;34(11):1958-1965. doi: 10.1038/s41433-020-0830-3. Epub 2020 Mar 19.
There has been a sharp rise of reported handheld laser-induced maculopathy (HLIM) cases over the past decade, a concerning trend that may continue due to unregulated online access to high power lasers. Though HLIM has distinct clinical features, not uncommonly it may masquerade as other retinal disorders. It is critical therefore to recognise the clinical and multimodal imaging characteristics of this important and potentially devastating condition. As HLIM patients are typically young, unique issues need to be considered, such as delayed presentation, difficult history, poor compliance and behavioural or psychiatric comorbidity. This article will review the clinical and diagnostic features of laser injury, with a special emphasis on the multimodal retinal findings. In addition, we present a unique case of HLIM, resembling the presentation of a placoid disease variant and illustrating choroidal ischaemia using advanced retinal imaging, that offers further insight into the mechanisms of laser injury and its complications. The issues addressed in this review aim to increase recognition of an increasingly important and trending condition with potentially profound visual complications.
在过去的十年中，报告的手持式激光诱导黄斑病变 (HLIM) 病例急剧增加，这种令人担忧的趋势可能会持续下去，因为未经监管的在线访问可以获得高功率激光器。尽管 HLIM 具有独特的临床特征，但它并不罕见，可能会伪装成其他视网膜疾病。因此，识别这种重要且潜在破坏性疾病的临床和多模态成像特征至关重要。由于 HLIM 患者通常很年轻，因此需要考虑独特的问题，例如延迟出现、难以提供病史、依从性差以及行为或精神共病。本文将回顾激光损伤的临床和诊断特征，特别强调多模态视网膜发现。此外，我们还介绍了一个 HLIM 的独特病例，其表现类似于盘状疾病变体，并使用先进的视网膜成像来说明脉络膜缺血，这进一步深入了解了激光损伤及其并发症的机制。本综述中讨论的问题旨在提高对一种日益重要且呈趋势的疾病的认识，这种疾病可能会导致严重的视觉并发症。
