Citation

Nghiem-Buffet S, Gaudric A, Cohen SY. Am. J. Ophthalmol. Case Rep. 2020; 17: 100578.

Affiliation

Department of Ophthalmology, Intercity Hospital and University Paris Est, 40 Avenue de Verdun, 94010, Creteil, France.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/j.ajoc.2019.100578

PMID

31909293

PMCID

PMC6939100

Abstract

PURPOSE: To report multimodal imaging of lesions due to the unprotected observation of the sun with an astronomical telescope, mimicking self-inflicted handheld laser-induced macular lesions. OBSERVATION: A 44-year old man was diagnosed with chronic central serous chorioretinopathy leaving a relative scotoma in his left eye, with visual acuity limited to 20/40. He complained of a sudden visual loss to 20/400. Fundus examination showed a yellowish discoloration of the fovea. Fundus autofluorescence pictures showed hyper-autofluorescent spots that were hyperfluorescent both on fluorescein and indocyanine-green angiography. Spectral-domain optical coherence tomography (SD-OCT) showed hyper-reflective foveal outer layers, and OCT-angiography showed dark areas at the choriocapillaris. Multimodal imaging was highly suggestive of self-inflicted handheld laser-induced lesions that were ruled out by the patient. He remembered having observed the sun during an astronomical session, looking for solar winds. The main astronomical telescope was protected by a specific filter, but the aiming side-telescope was incidentally not protected by any filter.

CONCLUSION AND IMPORTANCE: The unprotected observation of the sun with an astronomical telescope may result in visual loss due to macular burns that may mimic self-inflicted handheld laser-induced lesions. This hypothesis should be searched before concluding denied self-injuries.

© 2019 The Authors.

Language: en

Keywords

Central serous chorioretinopathy; Handheld laser; Retinal phototoxicity; Solar burn