Vitreous Retina Macula Consultants of New York, New York; and New York University Langone, New York, New York.
Retin Cases Brief Rep. 2024 Mar 1;18(2):177-180. doi: 10.1097/ICB.0000000000001374.
To report a case of a full-thickness macular hole after exposure to an extremely powerful handheld laser pointer.
A 14-year-old boy with a laser-induced full-thickness macular hole was evaluated 1 month after a momentary exposure to a 5,000 mW blue laser pointer. Imaging modalities including fundus color, autofluorescence, and spectral-domain optical coherence tomography, acquired both at our clinic and by the referring physician soon after the injury, are used to describe the clinical evolution of the case.
Soon after the injury, an intensely white, circular opacification of the retina approximately 400 μm in diameter was seen in the fovea. Early spectral-domain optical coherence tomography images showed full-thickness hyperreflectivity, likely representing tissue necrosis. One month later, a full-thickness macular hole and eradication of the retinal pigment epithelium at its base were evident in the fundus color, autofluorescence, and spectral-domain optical coherence tomography images.
High-power laser pointers have become easily available online. The presenting findings after exposure to such high-power devices are distinct from those reported after exposure to weaker laser pointers. Although long exposure to weaker lasers typically produces extensive, calligraphic figures and yellow placoid lesions involving only the outer retina, in our case, a very brief exposure led to focal full-thickness injury of the fovea.
报告 1 例因接触极强功率手持式激光笔而导致全层黄斑裂孔的病例。
对 1 名 14 岁男孩进行评估，该男孩在短暂接触 5000 mW 蓝色激光笔后 1 个月出现激光诱导的全层黄斑裂孔。使用眼底彩色照相、自发荧光和频域光相干断层扫描等成像方式，对受伤后在我们诊所和转诊医生处立即获得的图像进行描述，以描述该病例的临床演变过程。
受伤后不久，在黄斑中心凹可见约 400 μm 直径的强烈白色圆形视网膜混浊。早期频域光相干断层扫描图像显示全层高反射性，可能代表组织坏死。1 个月后，眼底彩色照相、自发荧光和频域光相干断层扫描图像显示全层黄斑裂孔，其底部的视网膜色素上皮完全消失。
高功率激光笔在网上变得容易获得。与接触较弱激光笔后的表现不同，接触如此高功率设备后的表现较为独特。虽然长时间接触较弱的激光笔通常会导致广泛的、书法状的、累及外视网膜的黄色斑片状病变，但在我们的病例中，短暂接触导致了黄斑中心凹的局灶性全层损伤。
