Optical Coherence Tomography Angiography Findings in Two Cases of Solar Retinopathy

Abstract

Purpose: To report optical coherence tomography angiography findings obtained in two patients with solar retinopathy.Methods: Two case reports.Results: Two patients presented with blurry vision after sun gazing during the recent solar eclipse and were found to have characteristic foveal lesions on examination and optical coherence tomography consistent with solar retinopathy. Optical coherence tomography angiography showed a focal area of nonperfusion of the choriocapillaris in the affected eyes.Conclusion: Changes to the choriocapillaris layer on optical coherence tomography angiography in two patients with solar retinopathy suggest that damage is not limited to the retina.

Case Report: Asymmetric Changes of Ophthalmic Findings in Bilateral Solar Eclipse Maculopathy

“…20 A previous study also measured the choroidal thickness post-acute solar exposure, revealing a significant decrease in mean macular thickness and increased mean choroidal thickness after 1 month. 21 Padidam et al 22 were the first to describe the focal nonperfusion of choriocapillaris in OCTA affected by eclipse gazing. The signal voids in the choriocapillaris layer of the macular zone were also noted at an angiography examination after 2 weeks.…”

The yellow fovea

“…The presence of drop-out areas in the choriocapillaries slab indicates the involvement of choriocapillaries in addition to the photoreceptors and retinal pigment epithelial cells. [ 2 ] It usually recovers spontaneously in 3–6 months, but majority of patients have residual central scotoma or reduced vision.…”

Clinical Photic Retinopathy: Mechanisms, Manifestations, and Misperceptions

“…6). (d) OCT angiography shows small choriocapillaris flow voids (open arrows) [181,309,310] also observed in photic retinopathy [183]. Superficial and deep capillary plexi were normal.…”

“…Threshold or mild burns can produce full-thickness foveolar OCT hyperreflectance acutely with long-term localized outer retinal hyporeflectance similar to photic retinopathy [181,308]. Figure 11 shows OCTA choriocapillaris flow abnormalities [181,309,310] also observed in solar retinopathy [183].…”

“…Curvilinear columns of hyperreflective Henle fibers may be present transiently after a solar injury [172,178,179], as in operating microscope [180] or threshold laser [181] injuries, possibly related to Henle layer waveguide propagation of photons to the foveola [68,182]. Choriocapillaris abnormalities have been detected in OCT angiography (OCTA) of solar retinopathy [183]. Subfoveal RPE hyperplasia can occur years after an injury [184].…”