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Sub-hyaloid and sub-internal limiting membrane macular hemorrhage after laser exposure at music festival: a case report

  • Carla Rocio Perez-Montaño
  • Jose Luis Palomares-Ordoñez
  • Abel Ramirez-Estudillo
  • Jorge Sanchez-Ramos
  • Gerardo González-SaldivarEmail author
Article

Abstract

Purpose

To describe the first case of a combined sub-hyaloid and sub-internal limiting membrane macular hemorrhage after recreational laser exposure.

Methods

A 23-year-old patient presented with an acute loss of vision in his right eye (OD) immediately after a brief exposure to a laser beam at a music festival. Color photography, spectral-domain optical coherence tomography (SD-OCT), and multifocal electroretinogram (mfERG) were performed for diagnosis and follow-up.

Results

On presentation, visual acuity was 20/400 in the OD and 20/20 in the left eye. Posterior segment examination of his OD revealed a preretinal hemorrhage at the macula. SD-OCT images exposed a combined sub-hyaloid and sub-internal limiting membrane localization. Successful VPP with ILM peeling was carried out. Although sequential mfERG displayed almost complete restoration of the P1 amplitude 6 months posterior to VPP, SD-OCT demonstrated permanent damage to outer retinal layers. Final BCVA on OD was 20/30.

Conclusion

The expanding and unregulated use of lasers in everyday life has created an increasing amount of cases of laser-induced retinopathy in recent years. Much more attention should be addressed in laser safety and awareness to prevent future ocular injuries. In acute phases of sub-hyaloid hemorrhages blocking direct visualization of the posterior pole, mfERG is a valuable tool to address initial macular pathology.

Keywords

Laser Laser-induced maculopathy Thermal retinopathy 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Data availability

Data generated during the course of the current study re available from the corresponding author on reasonable request.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Statement of human rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Statement on the welfare of animals

No animals were used in this study.

Supplementary material

10633_2018_9666_MOESM1_ESM.mp4 (27.5 mb)
A 23-G PPV + ILM peeling for pre-retinal hemorrhage was done. After hyaloidectomy, only a portion of the dehemoglobinized clot could be removed; the rest could only be removed after ILM peeling. This confirms the presence of the combined sub-hyaloid and sub-ILM hemorrhage

References

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Retina DivisionFundación Hospital Nuestra Señora de la LuzMexico CityMexico
  2. 2.Retina DivisionSt. Michael’s HospitalTorontoCanada

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