Kerala Journal of Ophthalmology

PHOTO ESSAY
Year
: 2022  |  Volume : 34  |  Issue : 2  |  Page : 174--175

Spectral domain optical coherence tomographic findings in Welder's maculopathy


Priya Rasipuram Chandrasekaran 
 Department of Medical Retina and Neuro-ophthalmology, Lotus Eye Hospital, Salem, Tamil Nadu, India

Correspondence Address:
Dr. Priya Rasipuram Chandrasekaran
Lotus Eye Hospital, Salem - 636 016, Tamil Nadu
India

Abstract

This photo essay shows the spectral domain optical coherence tomographic (SD OCT) findings in Welder's maculopathy. A 34-year-old welder presented with metamorphopsia and a best-corrected visual acuity of 20/30 N8 in both eyes, respectively. Fundus examination showed absent foveal reflex and revealed orange-red spot surrounded by a pigmentary halo. The corresponding SD OCT showed a rectangular-shaped solitary hyporeflective space called the outer retinal hole. The hole extends from the inner layer of the retinal pigment epithelium to external limiting membrane, which in turn corresponds to inner segment/outer segment photo receptor junction (IS/OS). The straight edges of the hole and the top surface at the level of IS/OS junction line are lined by hyperreflective material. Central subfield thickness was 205 μm and 209 μm, respectively. SD OCT findings were similar to photic/solar maculopathy.



How to cite this article:
Chandrasekaran PR. Spectral domain optical coherence tomographic findings in Welder's maculopathy.Kerala J Ophthalmol 2022;34:174-175


How to cite this URL:
Chandrasekaran PR. Spectral domain optical coherence tomographic findings in Welder's maculopathy. Kerala J Ophthalmol [serial online] 2022 [cited 2022 Dec 4 ];34:174-175
Available from: http://www.kjophthal.com/text.asp?2022/34/2/174/355033


Full Text



A 34-year-old welder presented with metamorphopsia and best-corrected visual acuity of 20/30 N8 in both eyes respectively. Fundus photo showed orange-red spot surrounded by a pigmentary halo [Figure 1]. Foveal reflex was absent. Spectral domain optical coherence tomography (SD OCT) of the macula showed a rectangular-shaped solitary hyporeflective space called the outer retinal hole (ORH). This extends from the inner layer of the retinal pigment epithelium (RPE) to external limiting membrane which corresponds to the inner segment/outer segment (IS/OS) junction. The straight edges of the hole and the top surface at the level of IS/OS junction are lined by a hyperreflective material [Figure 2] and [Figure 3]. Central subfield thickness measured was 205 μm and 209 μm, respectively. OCT characteristics were similar to that of photic/solar maculopathy.{Figure 1}{Figure 2}{Figure 3}

 Discussion



Radiation emitted by welding arc ranges from infrared to ultraviolet spectrum and beyond. Retinal damage is believed to be caused by visible light and near infrared spectrum. Ultraviolet and infrared spectrum damage the anterior segment structures.[1] Welding arc can lead to subretinal neovascularization[2] or burns in the macula that can cause permanent loss of central vision.[1] Ultrastructural findings in solar retinopathy demonstrated changes in the photo receptor OS as vesiculation and fragmentation of photo receptor lamellae and whorls within the disc membranes. Mitochondrial swelling and nuclear pyknosis were seen in the parafoveal rods.[3] Welder's maculopathy causes photochemical damage which damages the outer retina in contrast to thermal injury which damages the neurosensory retina. ORH is pathognomonic of Welder's maculopathy and is believed to be due to the accumulation of the damaged photoreceptor discs that could not be removed due to defective phagocytic function of RPE.[4] The hyperreflective lining of ORH could represent cellular debris.[5]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient (s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initial s will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorshipm

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Brittain GP. Retinal burns caused by exposure to MIG-welding arcs: Report of two cases. Br J Ophthalmol 1988;72:570-5.
2Kozielec GF, Smith CW. Welding arc-like injury with secondary subretinal neovascularization. Retina 1997;17:558-9.
3Hope-Ross MW, Mahon GJ, Gardiner TA, Archer DB. Ultrastructural findings in solar retinopathy. Eye (Lond) 1993;7 (Pt 1):29-33.
4Vedantham V. Optical coherence tomography finding in a case of chronic welder's maculopathy. Eye (Lond) 2006;20:269-71.
5Mahindrakar A, Toshniwal S, Doongerwala MI, Anthony H. Spectralis optical coherence tomography findings in Welder's maculopathy, Indian J Ophthalmol 2013;61:238-40.