J Korean Ophthalmol Soc.  2019 Dec;60(12):1344-1351. 10.3341/jkos.2019.60.12.1344.

Long-term Follow-up Results of Patients with Welding-arc Maculopathy Assessed Using Spectral Domain Optical Coherence Tomography

• Kim JH
• Kim BJ
• Kang TS
• Cho HK
• Nam KY
• Yoo JM
• Han YS

• KMID: 2466194
• DOI: http://doi.org/10.3341/jkos.2019.60.12.1344

Abstract

PURPOSE
We present four cases of welding arc maculopathy as observed using spectral-domain optical coherence tomography (SD-OCT).
CASE SUMMARY
Four patients, who performed welding without wearing protective eye gear, presented to the hospital due to poor visual acuity. The mean visual acuity of the patients was 0.6. Fundus photographs of the four patients revealed a yellowish retinal scar at the fovea. SD-OCT images of the four patients showed photoreceptor inner segment/outer segment junction (IS/OS junction) disruption and retinal pigment epithelium injury. We diagnosed the patients with welding arc maculopathy, and three of them were treated with oral steroids or antioxidants. The IS/OS junctions were restored in two patients, who had short welding arc exposures. The disrupted IS/OS junction recovered partially in one of the other two patients, who had a longer duration of exposure, and the IS/OS junction disruption remained in another patient.
CONCLUSIONS
We report four cases of welding arc maculopathy caused by welding light exposure evaluated using SD-OCT and treated with oral steroids and antioxidants.

Keyword

Maculopathy; Optical coherence tomography; Retinal pigment epithelium; Welding

MeSH Terms

Antioxidants
Cicatrix
Follow-Up Studies*
Humans
Retinal Pigment Epithelium
Retinaldehyde
Steroids
Tomography, Optical Coherence*
Visual Acuity
Welding
Antioxidants
Retinaldehyde
Steroids

Figure

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  Figure 1 (Patient 1) Fundus photograph (A) and SD-OCT image obtained (B) at the first ophthalmic examination showing a yellowish retinal scar in the fovea and IS/OS junction disruption, hyperreflective band in the outer nuclear layer and RPE injury in the left eye. Fundus photograph (C) and SD-OCT image (D) after 1 month of treatment showing IS/OS junction restoration, but the retinal scar at the fovea and RPE injury persisted in the left eye. Fundus photograph (E) and SD-OCT image (F) after 1 year of treatment showing complete restoration of the IS/OS junction. SD-OCT = spectral domain optical coherence tomography; IS/OS junction = photoreceptor inner segment/outer segment junction; RPE = retinal pigmented epithelium.

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  Figure 2 (Patient 2) Fundus photograph (A) and SD-OCT image (B) at the first ophthalmic examination showing yellowish retinal scar in the fovea and IS/OS junction disruption and RPE injury in the left eye. Fundus photograph (C) and SD-OCT image (D) after 1 year of treatment showing persistent IS/OS junction disruption, retinal scar in the fovea, and RPE injury. SD-OCT = spectral domain optical coherence tomography; IS/OS junction = photoreceptor inner segment/outer segment junction; RPE = retinal pigmented epithelium.

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  Figure 3 (Patient 3) Fundus photograph (A) and SD-OCT image (B) at the first ophthalmic examination showing yellowish retinal scar in the fovea and IS/OS junction disruption, hyperreflective band in the outer nuclear layer and RPE injury in the left eye. Fundus photograph (C) and SD-OCT image (D) after 1 years of treatment showing grater improvement in the IS/OS junction, RPE injury and retinal scar in the fovea. SD-OCT = spectral domain optical coherence tomography; IS/OS junction = photoreceptor inner segment/outer segment junction; RPE = retinal pigmented epithelium.

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  Figure 4 (Patient 4) Fundus photograph (A) and SD-OCT image (B) at the first ophthalmic examination showing yellowish retinal scar in the fovea and IS/OS junction disruption, RPE injury and hyporeflextive cystic lesion in the cone outer segment tips (interdigitation zone) in the right eye. Fundus photograph (C) and SD-OCT image (D) taken after 3 weeks, showing partially restored IS/OS junction and hyporeflextive cystic lesion with a persistent retinal scar in the fovea and RPE injury. SD-OCT = spectral domain optical coherence tomography; IS/OS junction = photoreceptor inner segment/outer segment junction; RPE = retinal pigmented epithelium.

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