Improved Diagnosis of Retinal Laser Injuries Using Near-Infrared Autofluorescence
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Improved Diagnosis of Retinal Laser Injuries Using Near-Infrared Autofluorescence. / De Silva, Samantha R; Neffendorf, James E; Birtel, Johannes; Herrmann, Philipp; Downes, Susan M; Patel, Chetan K; Hildebrand, G Darius; Gliem, Martin; Charbel Issa, Peter.
In: AM J OPHTHALMOL, Vol. 208, 12.2019, p. 87-93.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Improved Diagnosis of Retinal Laser Injuries Using Near-Infrared Autofluorescence
AU - De Silva, Samantha R
AU - Neffendorf, James E
AU - Birtel, Johannes
AU - Herrmann, Philipp
AU - Downes, Susan M
AU - Patel, Chetan K
AU - Hildebrand, G Darius
AU - Gliem, Martin
AU - Charbel Issa, Peter
N1 - Copyright © 2019 Elsevier Inc. All rights reserved.
PY - 2019/12
Y1 - 2019/12
N2 - PURPOSE: To assess whether near infrared autofluorescence (NIR-AF) imaging is a useful imaging modality in the diagnosis of handheld laser retinal injuries.DESIGN: Retrospective observational case series.METHODS: Twelve patients identified to have handheld laser retinal injuries were included at 2 academic centers. Patients underwent ophthalmic assessment and retinal imaging including fundus photography, optical coherence tomography (OCT), conventional blue autofluorescence (B-AF), and NIR-AF imaging.RESULTS: In all cases, lesions consistent with retinal laser injury were detected by NIR-AF imaging. The lesions showed a characteristic appearance with central hyperfluorescence and surrounding hypofluorescence, although the number and extent of lesions varied between patients. Findings using other imaging modalities were variable: on color fundus photography these included localized pigmentary changes and on OCT imaging an ellipsoid zone interruption or outer nuclear layer changes. Only subtle changes were evident on B-AF imaging. Other macular conditions, such as poppers retinopathy or solar maculopathy, which may have similar findings on OCT imaging as laser damage, can be differentiated using NIR-AF imaging.CONCLUSION: An increased incidence of retinal injuries secondary to handheld lasers has been reported in recent years. We show that the diagnosis and full extent of retinal laser injuries is best demonstrated by NIR-AF, as other modalities give variable results. We propose that NIR-AF should be included when investigating patients suspected of macular injury secondary to exposure to handheld lasers.
AB - PURPOSE: To assess whether near infrared autofluorescence (NIR-AF) imaging is a useful imaging modality in the diagnosis of handheld laser retinal injuries.DESIGN: Retrospective observational case series.METHODS: Twelve patients identified to have handheld laser retinal injuries were included at 2 academic centers. Patients underwent ophthalmic assessment and retinal imaging including fundus photography, optical coherence tomography (OCT), conventional blue autofluorescence (B-AF), and NIR-AF imaging.RESULTS: In all cases, lesions consistent with retinal laser injury were detected by NIR-AF imaging. The lesions showed a characteristic appearance with central hyperfluorescence and surrounding hypofluorescence, although the number and extent of lesions varied between patients. Findings using other imaging modalities were variable: on color fundus photography these included localized pigmentary changes and on OCT imaging an ellipsoid zone interruption or outer nuclear layer changes. Only subtle changes were evident on B-AF imaging. Other macular conditions, such as poppers retinopathy or solar maculopathy, which may have similar findings on OCT imaging as laser damage, can be differentiated using NIR-AF imaging.CONCLUSION: An increased incidence of retinal injuries secondary to handheld lasers has been reported in recent years. We show that the diagnosis and full extent of retinal laser injuries is best demonstrated by NIR-AF, as other modalities give variable results. We propose that NIR-AF should be included when investigating patients suspected of macular injury secondary to exposure to handheld lasers.
KW - Adolescent
KW - Child
KW - Eye Injuries/diagnostic imaging
KW - Female
KW - Fundus Oculi
KW - Humans
KW - Infrared Rays
KW - Lasers/adverse effects
KW - Male
KW - Multimodal Imaging
KW - Optical Imaging
KW - Photography
KW - Retina/injuries
KW - Retrospective Studies
KW - Scotoma/diagnostic imaging
KW - Tomography, Optical Coherence
KW - Visual Acuity/physiology
KW - Young Adult
U2 - 10.1016/j.ajo.2019.06.001
DO - 10.1016/j.ajo.2019.06.001
M3 - SCORING: Journal article
C2 - 31199894
VL - 208
SP - 87
EP - 93
JO - AM J OPHTHALMOL
JF - AM J OPHTHALMOL
SN - 0002-9394
ER -
