Name
Apport de l’OCT et de l’OCT-Angiographie dans la maculopathie photique

Merci de vous identifier pour accéder à ce contenu.

Je me connecte  


Orateurs :
Dr Rahma SAIDANE
Auteurs :
Dr Rahma SAIDANE
Dr Dhouha GOUIDER
Dr Racem CHOURA
Slim Selmi
Dr AFEF MAALEJ
Dr Asma KHALLOULI
Tags :
Résumé

Objectif

Photic maculopathy is damage to the macula, from prolonged exposure to solar radiation or other bright light (lasers or arc welders). This phototoxicity leads to oxidative damage to retinal pigment epithelium and the surrounding photoreceptors. . We aim to offer an integrated view of the three principal types of photic maculopathy and their tomographic features.We aim to offer an integrated view of the three principal types of photic maculopathy and their tomographic features.

Description de cas

A series of three patients with different photic maculopathies who underwent history taking and extensive ocular examination including best visual acuity (BVA), spectral domain optical coherence tomography (SD-OCT) and OCT-Angiography (OCT-A).

Observation

CASE 1: A 29-year-old man with history of sungazing presented with blurred vision and central scotoma in his left eye (LE) with a best corrected visual acuity (BCVA) limited to 65 letters (ETDRS) associated with a round, yellowish-white discoid lesion. SD-OCT showed a discontinuity of the interdigitation zone. OCT-A was normal .

CASE 2: A 26-year-old man with a history of self-inflicted handheld laser exposure presented with blurred vision in his LE with a BCVA limited to 85 letters in both eyes. Fundus examination disclosed bilateral and asymmetric yellow macular lesions. SD-OCT revealed ellipsoid zone disruption and the retrofoveal pigment epithelium more marked in the LE. OCT-A didn’t show obvious abnormalities except for a localized rupture of the peri-foveal anastomotic arcade, resulting in an irregular central avascular zone with hyporeflective zones in the outer retina and the choriocapillary .

CASE 3: A 25-year-old man performed electric arc welding for few minutes without wearing protective device and subsequently experienced eye discomfort and blurry vision in both eyes with a BCVA limited to 85 letters in the right eye and 20 letters in the LE. Fundus examination showed a yellowish spot in the macula with loss of foveal reflection in the LE. SD-OCT showed subfoveal, hyporeflective rectangle with straight edges in ellipsoid zone and photoreceptor outer segments in the LE. OCT-A was normal.

Discussion

SD-OCT imaging has been thought a great advance in the diagnosis of photic maculopathy. The characteristic anatomic changes in the acute phase are a consequence of the high metabolic rate that causes shedding in the outer retinal segment components. OCTA is a novel noninvasive imaging technique. Few studies described the OCTA finding in photic maculopathy. OCT-A of choriocapillaris layer was normal in acute photic retinopathy however several factors contribute to photic-related retinal damage and, these can be divided into two categories, patient related factors (size of the pupil, degree of retinal pigmentation, proximity of incident beam to the fovea; and refraction status) and radiation-related factors.

Conclusion

SD-OCT and OCT-A are promising imaging techniques, whose use in the study of photic maculopathy can bring informations in vivo to better understand its physiopathological mechanism.