Accidental foveal burn following pan retinal photocoagulation and its long-term outcome

Abstract

International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations.IJCRI publishes Review Articles, Case Series, Case Reports, Case in Images, Clinical Images and Letters to Editor. Website: www.ijcasereportsandimages.comAccidental foveal burn following pan retinal photocoagulation and its long-term outcome Khan Perwez, Pandey Kankambari, Khan Lubna, Saxena Nutan ABSTRACT Introduction: Changing lifestyle has led to rising trend of diabetes and its complications. There is an increased incidence of diabetic retinopathy with subsequent increased use of double frequency Nd:YAG lasers. Knowledge about the consequences of accidental exposure of these lasers and longterm prognosis will help us in better management of such accidents. Case Report: A 65-year-old female patient who sustained accidental double frequency Nd: YAG laser foveal burn while undergoing left eye panretinal photocoagulation (PRP) for diabetic retinopathy is presented with subsequent five years follow-up. Upon initial evaluation, best-corrected visual acuity (BCVA) of affected eye was count finger at 1 foot (CF 1') left eye. Immediate funduscopic examination revealed foveal laser burn. Corticosteroids, in the form of 40 mg prednisolone, were administered orally for two weeks followed by 10 mg per week taper along with long-term topical nepafenac three times a day. Fifteen days after exposure, funduscopic examination revealed a distinct foveal scar followed by epiretinal membrane formation at six months follow-up. The BCVA of the affected eye improved to 20/60 over a period of five years. This clinical course is different from those of previously reported cases where visual acuity did not recover. Conclusion: Accidental exposure of double frequency Nd:YAG laser to fovea can lead to grievous injury with loss of vision. Prompt use of high dose systemic steroids, topical non-steroidal antiinflammatory drops and natural healing can have better visual outcome.