Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Optom Vis Sci. 2023 May 1;100(5):339-345. doi: 10.1097/OPX.0000000000002012. Epub 2023 Mar 22.
A more profound understanding of the relationship between ophthalmic findings and eye dominance is needed to guide the timely and proper treatment of binocular photic maculopathy or other macular degeneration.
A patient with binocular solar maculopathy presented with asymmetric ophthalmic manifestations and changes during 14 months of observation. Early recognition of solar maculopathy can be vital for early diagnosis and better prognosis.
A 21-year-old man was reported to have blurred vision after staring directly at an annular solar eclipse several times for a few seconds on June 21, 2020. His Snellen best-corrected visual acuity declined to 20/50 in both eyes. He was right-eye dominant according to the hole-in-the-card test. The funduscopy found a yellow spot in the center of both maculae. Spectral-domain optical coherence tomography images revealed a full-thickness hyperreflectivity extending from the inner retinal layers to the retinal pigment epithelium (RPE) along with a localized disruption of the ellipsoid portion of the inner segments and RPE in both eyes. The medical history and clinical manifestations described previously supported the diagnosis of solar maculopathy. Spectral-domain optical coherence tomography images during follow-up indicated a diminishing disruption of the ellipsoid portion of the inner segments and RPE without treatment. Interestingly, the nondominant left eye made a better anatomical recovery. Finally, the Snellen best-corrected visual acuity remained 20/20 in both eyes after 14 months.
Binocular solar maculopathy can present asymmetrically and recover asymmetrically as well. The dominant eye suffered more obvious damage and poorer anatomical recovery than the nondominant eye.
为了指导双眼光凝性黄斑病变或其他黄斑变性的及时和适当治疗，需要更深入地了解眼科发现与眼优势之间的关系。
一名双眼太阳性黄斑病变患者表现出不对称的眼部表现，并在 14 个月的观察期间发生变化。早期识别太阳性黄斑病变对于早期诊断和更好的预后至关重要。
2020 年 6 月 21 日，一名 21 岁男性报告在直视几次几秒钟的环形日食后出现视力模糊。他的 Snellen 最佳矫正视力在双眼均下降至 20/50。他根据孔卡测试为右眼优势眼。眼底检查发现双眼黄斑中心均有黄斑黄点。频域光相干断层扫描图像显示，双眼全层视网膜内层至视网膜色素上皮（RPE）的高反射性延伸，伴有内外节和 RPE 的椭圆体部分局部中断。先前描述的病史和临床表现支持太阳性黄斑病变的诊断。随访的频域光相干断层扫描图像表明，在没有治疗的情况下，内外节和 RPE 的椭圆体部分中断逐渐减少。有趣的是，非优势左眼的解剖恢复更好。最后，14 个月后，双眼的 Snellen 最佳矫正视力仍保持在 20/20。
双眼太阳性黄斑病变可能表现出不对称性，并且恢复也可能不对称。优势眼比非优势眼遭受更明显的损伤和更差的解剖恢复。
