J.ophthalmol.(Ukraine).2017;3:37-42.

https://doi.org/10.31288/oftalmolzh201733742

Retinal injuries secondary to consumer laser devices in children

N.F. Bobrova, Dr Sc (Med), Prof.

T.A. Sorochinskaya, Cand Sc (Med)

L. A. Sukhodoeva, Cand Sc (Med)

E.V. Ivanitskaya, Cand Sc (Med)

N.I. Bakhmatskaya

I.M. Levitsky

Filatov Institute of Eye Diseases and Tissue Therapy of the NAMS of Ukraine, Odessa, Ukraine

E-mail: filatov_detskoe@mail.ru

Background: In recent years, increased incidence of retinal injuries secondary to consumer laser devices (predominantly, pointers and those used at disco clubs) in children and adolescents have been observed.

Purpose: To review the clinical features and structural retinal changes in the macula in pediatric patients following an injury secondary to laser ‘toys’.

Materials and Methods: We retrospectively reviewed charts of 5 pediatric patients with retinal laser-induced burns (3 patients with fresh burns, and 2 patients who had a burn injury 1 year and 5 years before). Three patients, one patient and a 16-year-old girl (patient No. 5) received retinal burns from laser pointer, laser flashlight and at a disco club, respectively. On fundus examination, a blurred macular reflex, and 1 to 3 macular foci with pigmentation at the periphery of these foci were noted in three patients with 3 patients with fresh burns. In addition, in patient No. 5, an extensive round-shaped retinal hemorrhage was visualized, and the OCT demonstrated high optical density regions in the fovea under the inner limiting membrane, perifocal areas of thickened internal retinal layers the and loss of the retinal layer structure. In the patient who had a burn injury 5 years before, small foci of RPE atrophy similar to that of retinitis solaris were seen.

Results: Patients with fresh burns received systemic and topical antitoxic, dehydration and antioxidant therapy. Laser posterior hyaloidotomy was performed in the patient with retinal hemorrhage. After treatment, in all patients, visual acuity improved substantially from 0.4 with myopic correction to 0.5-0.7.

Conclusion: Although complete restoration of retinal foveal structure following pediatric injuries secondary to consumer laser products seems not possible, their timely comprehensive treatment enable high functional outcomes for these patients.

Key words: retina, laser burns, children              

References

  1. Alsulaiman SM, Alrushood AA, Almasaud J, et al. High-power handheld blue laser-induced maculopathy: The results of the King Khaled Eye Specialist Hospital Collaborative Retina Study Group. Ophthalmology. 2014;121:566–72.e1.
    Crossref   Pubmed
  2. Durukan AH, Kerimoglu H, Erdurman C, et al. Long-term results of Nd: YAG laser treatment for premacular subhyaloid haemorrhage owing to Valsalva retinopathy. Eye (Lond). 2008;22:214–8.
    Crossref   Pubmed
  3. Harris MD, Lincoln AE, Amoroso PJ, et al. Laser eye injuries in military occupations. Aviat Space Environ Med. 2003;74:947–52.
  4. Hossein M, Bonyadi J, Soheilian R, et al. SD-OCT features of laser pointer maculopathy before and after systemic corticosteroid therapy. Ophthalmic Surg Lasers Imaging. 2011;42:e135–8.
    Crossref   Pubmed
  5. Kasaoka M, Ma J, Lashkari K. c-Met modulates RPE migratory response to laser-induced retinal injury. PLoS One. 2012;7:e40771.
    Crossref   Pubmed
  6. Robertson DM, McLaren JW, Salomao DR, Link TP. Retinopathy from a green laser pointer: A clinicopathologic study. Arch Ophthalmol. 2005;123:629–33.
    Crossref   Pubmed
  7. Wyrsch S, Baenninger PB, Schmid MK. Retinal injuries from a handheld laser pointer. N Engl J Med. 2010;363:1089–91.
    Crossref   Pubmed
  8. Raoof N, Chan TK, Rogers NK et al. ‘Toy' laser macular burns in children. Eye (Lond). 2014 Feb; 28(2): 231–4.
    Crossref   Pubmed
  9. Allen RD, Brown J, Jr, Zwick H, Schuschereba ST, et al. Laser-induced macular holes demonstrate impaired choroidal perfusion. Retina. 2004;24:92–7.
    Crossref   Pubmed
  10. ANSI Z136.1-2000. Washington, DC: American National Standards Institute; 2000. American National Standard for the Safe Use of Lasers.
  11. Mainster MA, Stuck BE, Brown J, Jr. Assessment of alleged retinal laser injuries. Arch Ophthalmol. 2004;122:1210–7.
    Crossref   Pubmed
  12. Keunen JE, Delbecq AL, Cruysberg JR, et al. Laser pointers are not toys; eye injury with permanent loss of visual acuity. Ned Tijdschr Geneeskd. 2014;158:A7813.
  13. Lim ME, Suelzer J, Moorthy RS, Vemuri G. Thermal macular injury from a 154 mW green laser pointer. J AAPOS. 2014 Dec;18(6):612-4.
    Crossref   Pubmed
  14. Ozawa T1. Laser pointer and laser safety standard. Nippon Ganka Gakkai Zasshi. 2001 Oct;105(10):653-8.
  15. Thanos S, B?hm MR, Meyer zu H?rste M, Schmidt PF. Retinal damage induced by mirror-reflected light from a laser pointer. BMJ Case Rep. 2015.
    Crossref   Pubmed
  16. Weng CY, Baumal CR, Albini TA, Berrocal AM. Self-induced laser maculopathy in an adolescent boy utilizing a mirror. Ophthalmic Surg Lasers Imaging Retina. 2015 Apr;46(4):485-8.
    Crossref   Pubmed
  17. Shenoy R, Bialasiewicz AA, Bandara A. Retinal Damage from Laser Pointer Misuse – Case Series from the Military Sector in Oman. Middle East Afr J Ophthalmol. 2015 Jul-Sep; 22(3): 399–403.
    Crossref   Pubmed
  18. Turkana K, Bryan JS, Gordon AJ, et al. Laser pointer induced macular damage: case report and mini review. Int Ophthalmol. 2012;32 (3):293–7.               
    Crossref   Pubmed