New approaches to the diagnosis and management of laser eye injury
2007
The emergence of high resolution optical coherence tomography (OCT) along with evidence showing
beneficial effects of anti-inflammatory drugs for retinal edema and neovascularization suggests a rational
plan for the diagnosis and management of patients with acute laser eye injury. We review the results of
recent experiments we conducted to evaluate treatment of laser lesions followed by reports of two cases of
acute laser eye injury with foveal involvement. The initial presentation of these cases was notable for the
lack of significant abnormalities on fluorescein angiography whereas OCT readily disclosed the size and
extent of retinal involvement from exposure to laser energy. Prompt referral of these cases resulted in rapid
initiation of medical therapy which included a 10-14 day combined course of steroid and non-steroidal anti-inflammatory
medication. An initial decrease in Snellen visual acuity of approximately two lines (20/25- to
20/30) was noted on presentation. In both cases, a measurable improvement of visual acuity was noted by
two weeks post injury. The use of anti-inflammatory medication may enhance the initial recovery of vision
and reduce the likelihood of longer term retinal complications from scarring and neovascularization.
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