Detection of Retinal Affection among Arc Welders Using Optical Coherence Tomography

Introduction: Arc welders are at high risk for developing phototoxic maculopathy, as diagnosed by using Optical Coherence Tomography (OCT), which describes some structural changes in the fovea of welders with maculopathy, as disruption of the inner high reflective layer corresponding to the outer neurosensory retina. Aim of work: To evaluate the use of Optical Coherence Tomography (OCT) as a method for monitoring workers involved in arc welding for early detection of any retinal damage. Materials and methods: The study included 66 exposed workers in an automobile factory in Helwan, Cairo. A matched group of 66 control subjects were included from administrative workers in the same factory. Diabetic and hypertensive were excluded from both groups. The studied groups were subjected to full history taking including occupational history, clinical eye examination, fundus examination using ophthalmoscope, Best Corrected Visual Acuity testing (BCVA) and Optical Coherence Tomography testing. Results: All exposed workers reported using welding goggles or face shield during welding. Diminution of vision and manifestations of photo-kerato-conjunctivitis were significantly more prevalent among exposed group compared to the controls. Best Corrected Visual Acuity (BCVA) was significantly lower among the exposed group with significant negative correlation between BCVA and duration of exposure. Fundus ophthalmoscopic examination of the exposed group revealed yellowish spots of the macula and fovea. OCT findings among the exposed workers included mainly macular edema, inner/outer segment disruption of the retinal pigment epithelium and macular thinning. Conclusion: OCT is useful in the diagnosis of welders’ maculopathy. Using welding goggles and face shield might not provide enough protection against welders’ maculopathy.