Impact of Solar Eclipses on Vision: Insights from Optical Coherence Tomography and Optical Coherence Tomography Angiography Analysis.

PURPOSE: Solar retinopathy, resulting from solar eclipse exposure, poses risks to visual health. This study explores acute and chronic phase findings using clinical examinations and optical coherence tomography (OCT) and optical coherence tomography angiography (OCT-A) with a focus on longitudinal assessment. METHODS: Seven eyes with a history of unprotected solar eclipse exposure were included. Clinical examination, fundus photography, OCT, and OCT-A imaging were performed at initial assessment, as well as at one-month and six-month follow-up intervals. Data analysis included descriptive statistics. RESULTS: The cases, exposed without protection, underwent assessments, revealing variable visual acuity, outer retinal layer, and Henle fiber layer changes during follow-up. Regression of hyperreflectivity within the outer retinal and Henle fiber layers was observed over time in all eyes, although persistent microdefects within the outer retinal layer were noted in specific cases. OCT-A imaging revealed a larger foveal avascular zone, which persisted over a six-month period in select cases. Additionally, affected eyes exhibited a decrease in superficial vascular density, with subsequent improvement noted during the six-month period. CONCLUSION: Solar retinopathy can result in visual impairment, accompanied by alterations observed in the Henle fiber layer using OCT. Additionally, OCT-A findings indicate possible vascular involvement. This study underscores the significance of adopting protective measures during solar eclipses and emphasizes the value of employing longitudinal multimodal imaging techniques to comprehend the pathophysiology of the condition.

Multimodal Imaging for Subacute Sclerosing Panencephalitis: Including Anterior Segment.

Subacute sclerosing panencephalitis (SSPE) is an irreversible and progressive neurological disorder. A 20-year-old woman with SSPE presented with a decline in visual acuity. Anterior segment was evaluated with slit lamp and in vivo confocal microscopy, revealing the presence of dendritiform keratic precipitates and +2 cells in the anterior chamber. In fundus examination, white-yellowish lesions involving the macula and periphery were observed, which gradually progressed into atrophy over time. Optical coherence tomography (OCT) imaging showed progression to atrophy of moth-eaten shaped cavities including all retinal layers due to necrotizing retinitis. OCT angiography (OCTA) further revealed reduced vessel densities and flow void areas. Notably, to the best of our knowledge, this is the first case documenting anterior segment findings in SSPE in detail. [Ophthalmic Surg Lasers Imaging Retina 2024;55:344-348.].

Spontaneous hyphema in juvenile idiopathic arthritis uveitis.

BACKGROUND: Juvenile idiopathic arthritis (JIA) is a rheumatic disease that may be associated with ocular involvement in childhood. Classical findings of JIA uveitis are cells and flare; hyphema, bleeding in the anterior chamber of the eye, is a rare finding. CASE: An 8-year-old girl presented with 3+ cells and a flare in the anterior chamber. Topical corticosteroids were started. A follow-up examination 2 days later revealed hyphema in the affected eye. There was no history of trauma or drug use, and the laboratory test results did not suggest any hematological disease. Systemic evaluation resulted in the diagnosis of JIA by the rheumatology department. The findings regressed with systemic and topical treatment. CONCLUSIONS: The most common cause of hyphema in childhood is trauma, but it can rarely be seen with anterior uveitis. This case highlights the importance of recognizing JIA-related uveitis in the differential diagnosis of hyphema in childhood.

Multimodal Imaging of Severe Oxalate Retinopathy in a 20-Month-Old Boy.

Primary hyperoxaluria type 1 (PH1) is a rare disease due to alanine glyoxylate aminotransferase enzyme deficiency caused by mutations in AGXT gene. Increased oxalate causes crystalline deposits in the eye particularly in conjunctiva, cornea, iris, retina, and choroid. A 20-month-old boy was referred with a diagnosis of infantile PH1. There were numerous yellowish crystalline deposits at the posterior pole and hyperpigmented lesions were detected around the macula. Enhanced depth imaging optical coherence tomography (EDI-OCT) revealed dome-shaped retinal pigment epithelium elevations, subretinal and intraretinal hyperreflective material and also choroidal hyperreflective lesions. To the best of our knowledge, this is the first case to document choroidal deposition by EDI-OCT at such an early period of life. [Ophthalmic Surg Lasers Imaging Retina 2022;53:697-700.].