Abstract
Purpose. Solar retinopathy is a rare clinical disturbance, for which spectral-domain optical coherence tomography (SD-OCT) findings are not always consistent. We report on two cases of solar retinopathy and discuss its differential diagnosis. Methods. This is an observational case study. Results. A 12-year-old female was referred to ophthalmology for bilateral scotoma. Visual acuity was 20/50 in both eyes. Fundus examination was unremarkable, except for slight yellowish material in the central macula, bilaterally. SD-OCT revealed juxtafoveal microcystic cavities in the outer retina, interruption of the external limiting membrane and the inner and outer segment junctions, with disorganized material in the vitelliform space. Fundus autofluorescence showed hypoautofluorescence surrounded by a relatively hyperautofluorescent ring, bilaterally. Similar clinical and morphological findings were detected in a 27-year-old male. Conclusions. Solar retinopathy has a subtle presentation and patients often deny sun-gazing. SD-OCT and fundus autofluorescence are noninvasive and useful tools for its diagnosis.
Highlights
Solar retinopathy is a rare ocular lesion that can result from unprotected solar eclipse viewing and from minimal gazing at the sun
Fundus autofluorescence (FAF) is a relatively new and noninvasive technique that is based on the autofluorescent properties of retinal fluorophores, such as lipofuscin, which is mainly located in the retinal pigment epithelium (RPE)
We report here on the clinical, spectral-domain optical coherence tomography (SD-OCT) and FAF imaging findings from four eyes of two subjects with mild RPE damage following unprotected sun-gazing
Summary
Solar retinopathy is a rare ocular lesion that can result from unprotected solar eclipse viewing and from minimal gazing at the sun. Spectral-domain optical coherence tomography (SDOCT) is a noninvasive imaging technique that is useful for the detection of foveal impairment and to outline the location and extension of retinal injury from acute solar retinopathy [2]. Acute solar retinopathy can sometimes share biomicroscopic and SD-OCT foveal findings with pathologies such as whiplash injury, sunbed exposure, ocular trauma, the initial stages of an idiopathic macular hole, persistent retinal defects following successful macular hole repair, idiopathic parafoveal telangiectasis, and solitary macular cysts [3, 4]. FAF represents an effective tool to detect subtle changes in the RPE and to provide a better understanding of the pathophysiology of solar retinopathy. We report here on the clinical, SD-OCT and FAF imaging findings from four eyes of two subjects with mild RPE damage following unprotected sun-gazing
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