Case series of solar retinopathy: Role of multi- modal imaging and role of hyper-reflective spots on SD-OCT as a prognostic factor - A follow-up study

摘要

Purpose: To document the visual acuity, spectral-domain optical coherence tomography (SD-OCT) findings with or without HRS, Multi-modal imaging (Multicolour image, IR and FAF), and prognosis in 9 eyes of 5 patients with foveal damage from solar retinopathy & to evaluate the visual recovery and OCT changes on follow-up at 6 months. Methods: This was a prospective, observational case series of patients with solar retinopathy at the Retina department, Aravind Eye Hospital, Pondicherry. All patients underwent visual acuity (VA) testing, refraction, dilated fundus examination - Red free fundus, Autofluorescence, and SD-OCT (spectral Domain ocular coherence Tomography) imaging and follow up for 6 months. Results: The mean age was 19 years (range 9-32 years, both eyes are affected in 4 patients. The visual acuity of the affected eyes ranged from 0.4-0.9 on presentation. At presentation, Significant foveal pathology was identified on SD-OCT in all eyes, with disruption of the photorecep-tor ellipsoid zone and the interdigitation zone and HRS. Follow-up at six months. 100% of cases showed improvement in OCT features but only 40% showed complete resolution with improvement in VA. The outer retinal hole persists in OCT in 60% of cases. Degree of resolution correlated with presenting visual acuity, younger age, degree of disruption of outer retina and presence of HRS in posterior vitreous. On multi-modal imaging, Autofluorescence correlates best with the presence of persistent outer retina disruption on OCT and final VA. Conclusion: Solar retinopathy has a good prognosis yet no improvement is noted after three months. Young age with poor VA at presentation and presence of HRS on SD-OCT might pose as poor prognostic factors.