Glyxambi
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 
  • Users Online: 11294
  • Home
  • Print this page
  • Email this page

   Table of Contents      
OPHTHALMIC IMAGE
Year : 2019  |  Volume : 67  |  Issue : 5  |  Page : 692

Operating microscope and endoilluminator-induced retinal phototoxic maculopathy after trans-scleral sutured posterior chamber intraocular lens


Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India

Date of Web Publication22-Apr-2019

Correspondence Address:
Dr. Mohit Dogra
Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1233_18

Rights and Permissions

How to cite this article:
Dogra M, Singh SR, Dogra MR. Operating microscope and endoilluminator-induced retinal phototoxic maculopathy after trans-scleral sutured posterior chamber intraocular lens. Indian J Ophthalmol 2019;67:692

How to cite this URL:
Dogra M, Singh SR, Dogra MR. Operating microscope and endoilluminator-induced retinal phototoxic maculopathy after trans-scleral sutured posterior chamber intraocular lens. Indian J Ophthalmol [serial online] 2019 [cited 2019 Nov 23];67:692. Available from: http://www.ijo.in/text.asp?2019/67/5/692/256658



A 64-year-old male complained of poor visual gain following vitrectomy with trans-scleral fixation of posterior chamber intraocular lens (PCIOL) in his right eye (RE). The surgery lasted two and a half hours and a xenon light source was used for endoillumination. RE had a best corrected visual acuity (BCVA) of 6/36, centered PCIOL, and an amoeboid area of pigmentary alteration at the fovea. Short-wave autofluorescence showed well-demarcated perifoveal hyperautofluorescent areas with spectral domain optical coherence tomography showing loss of photoreceptors and retinal pigment epithelium (RPE) thickening. Diagnosis of microscope and endoilluminator light-induced phototoxic maculopathy was made.[1],[2] Despite a 6-week course of oral steroids, he continued to worsen. At 1-year follow-up he had a hyperpigmented foveal scar with BCVA of 4/60 [Figure 1]a,[Figure 1]b,[Figure 1]c,[Figure 1]d,[Figure 1]e,[Figure 1]f,[Figure 1]g,[Figure 1]h,[Figure 1]i. Use of spectral filters and mechanical barriers over the cornea helps to reduce its incidence.[3],[4]
Figure 1: (a, b, and c) Showing pigmentary change at the fovea with pinpoint hyperautofluorescence and hyperautofluorescence rim (red arrow) having disruption of external limiting membrane (ELM) and ellipsoid zone (EZ) (green arrow). (d, e, and f) showing increase in pigmentary change at the fovea, loss of hyperautofluorescence rim and speckled hyper-hypoautofluorescence along with RPE hyperplasia (red arrow) and partial recovery of ELM and EZ (green arrow) at 2 months. (g, h, and i) showing a hypoautofluorescence hyperpigmented foveal scar (yellow arrow) with peripheral isoautofluorescence areas (red arrow) and pigment migration into the inner retina (blue arrow) at 1 year

Click here to view


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 initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Kweon EY, Ahn M, Lee DW, You IC, Kim MJ, Cho NC. Operating microscope light-induced phototoxic maculopathy after transscleral sutured posterior chamber intraocular lens implantation. Retina 2009;29:1491-5.  Back to cited text no. 1
    
2.
Oh SH, Kim KS, Lee WK. Outer retinal changes in endoilluminator-induced phototoxic maculopathy evident on spectral-domain optical coherence tomography. Clin Exp Optom 2015;98:381-4.  Back to cited text no. 2
    
3.
Michels M, Lewis H, Abrams GW, Han DP, Mieler WF, Neitz J. Macular phototoxicity caused by fiberoptic endoillumination during pars plana vitrectomy. Am J Ophthalmol 1992;114:287-96.  Back to cited text no. 3
    
4.
Coppola M, Cicinelli MV, Rabiolo A, Querques G, Bandello F. Importance of light filters in modern vitreoretinal surgery: An update of the literature. Ophthalmic Res 2017;58:189-93.  Back to cited text no. 4
    


    Figures

  [Figure 1]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
References
Article Figures

 Article Access Statistics
    Viewed308    
    Printed2    
    Emailed0    
    PDF Downloaded88    
    Comments [Add]    

Recommend this journal