Abstract
Purpose To report the clinical course of solar retinopathy after steroid therapy. Case Presentation A 45-year-old male gazed at the sun and noticed bilateral central scotoma and decreased vision after the episode. After 7 weeks from onset, ophthalmic examinations were firstly performed. Decimal best corrected visual acuity (BCVA) was decreased to 0.8 and 0.7 in the right and left eyes. Funduscopy showed a tiny, yellowish spot in the fovea bilaterally. Corresponding to the lesion, optical coherence tomography (OCT) images showed an elevated and blurred ellipsoid zone and loss of the interdigitation zone. A posterior sub-Tenon triamcinolone injection in the right eye and oral prednisolone therapy were performed as a medication. BCVA was improved to 1.2 and 1.0 in the right and left eyes at 9 weeks after medication. OCT images showed ellipsoid zone was gradually improved bilaterally, which became nearly normal at 4 weeks in the right eye and at 21 weeks in the left eye. The loss of the interdigitation zone remained at 12 weeks in the right eye and at 21 weeks at the left eye. Conclusions We described a case with solar retinopathy who exhibited anatomical recovery of the photoreceptor outer layers by steroid therapy, started after 7 weeks from onset.
Highlights
Symptoms of solar retinopathy include decreased vision, central scotoma, photophobia, and chromatopsia after gazing at the sun during solar eclipses or a typical sunny day [1]
Fluorescein angiography, optical coherence tomography (OCT), and fundus autofluorescence imaging (FAF) have all shown that damage to the retina during the acute phase of solar retinopathy generally exhibits abnormalities of the photoreceptor cells and retinal pigment epithelium at the fovea [3,4,5,6]
OCT images obtained during the first examination of the present case showed the presence of tiny, yellowish spots at the fovea and ellipsoid zone/interdigitation zone abnormalities
Summary
Symptoms of solar retinopathy include decreased vision, central scotoma, photophobia, and chromatopsia after gazing at the sun during solar eclipses or a typical sunny day [1]. Histopathological studies have confirmed that energy from sunlight is absorbed into melanosomes of the retinal pigment epithelium, which can lead to solar retinopathy with thermal and photochemical damage to the photoreceptor cells and retinal pigment epithelium [2]. Clinical studies using multimodal imaging including optical coherence tomography (OCT) and fundus autofluorescence imaging (FAF) have reported finding changes of the photoreceptor cells and retinal pigment epithelium during the acute phase and an increased choroidal thickness due to photic injury during the chronic phase [3,4,5]. We report a case of solar retinopathy in which the subject initially underwent ophthalmic examinations at 7 weeks after the onset of decreased vision and subsequent administration of steroid therapy. The purpose of this study was to report the clinical course of solar retinopathy during the subacute phase after undergoing steroid therapy
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