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Saudi Arabia: Handheld blue-light lasers can cause macular hole in retina
Scientists and physicians in Saudi Arabia reported that momentary exposure to high-power blue-light handheld lasers can cause a full-thickness mhole in the macula, the oval-shaped area near the center of the retina. Damage to this area causes loss of central vision.
The study, reported in the July 2015 American Journal of Ophthalmology, looked at 17 eyes of 17 patients at two institutions, between January 2012 and May 2014. Most were youths (mean patient age 18 years; range: 11 to 30 years old). The eyes were exposed to blue laser light for less than one second, at a mean distance estimated to be about 1 meter from the laser. The time from exposure to the patient visiting the hospital for treatment ranged from two days, to almost 500 days.
Patients were given a full ophthalmic examination, including fundus photography, macular spectral-domain optical coherence tomography, and fundus fluorescein angiography.
The macular holes ranged from 0.17 millimeters to 0.62 mm, with a mean diameter of 0.35 mm.
In 14 of the eyes, surgeons went deep into the eye and removed vitreous gel (a pars plana vitrectomy); this removes clouded gel that may contain blood from the injury. At the same time surgeons also did a procedure called “internal limiting membrane peeling,” which uses an instrument to make a break in the membrane which is then peeled away with forceps.
In 11 of the 14 eyes, the operation completely closed the macular hole. Of the other three unoperated eyes, the eye with the smallest macular hole spontaneously closed.
Before the operation, the mean Snellen best corrected visual acuity (BCVA) was 20/210, or about 1/10th the normal visual acuity; the range was from 20/30 to 2/200. After the operations, the mean BCVA was 20/62 (range: 20/20 to 4/200). These statistics included all eyes (the 14 operated eyes and the three unoperated ones).
The authors concluded “Full-thickness MH can result from momentary exposure to high-power handheld laser devices. While spontaneous closure may occur in rare cases, most cases require early surgical intervention. Vitrectomy may be successful in closing the macular hole with visual acuity improvement in most of the cases.”
From the abstract of the study by Alsulaiman SM, et al., “Full-Thickness Macular Hole Secondary to High-Power Handheld Blue Laser: Natural History and Management Outcomes” in the American Journal of Ophthalmology, July 2015 Vol. 160, Issue 1, Pages 107-113.e1.
Note: Other studies have been published based on this data, an August 2013 LaserPointerSafety.com story about the first study is here.
The study, reported in the July 2015 American Journal of Ophthalmology, looked at 17 eyes of 17 patients at two institutions, between January 2012 and May 2014. Most were youths (mean patient age 18 years; range: 11 to 30 years old). The eyes were exposed to blue laser light for less than one second, at a mean distance estimated to be about 1 meter from the laser. The time from exposure to the patient visiting the hospital for treatment ranged from two days, to almost 500 days.
Patients were given a full ophthalmic examination, including fundus photography, macular spectral-domain optical coherence tomography, and fundus fluorescein angiography.
The macular holes ranged from 0.17 millimeters to 0.62 mm, with a mean diameter of 0.35 mm.
In 14 of the eyes, surgeons went deep into the eye and removed vitreous gel (a pars plana vitrectomy); this removes clouded gel that may contain blood from the injury. At the same time surgeons also did a procedure called “internal limiting membrane peeling,” which uses an instrument to make a break in the membrane which is then peeled away with forceps.
In 11 of the 14 eyes, the operation completely closed the macular hole. Of the other three unoperated eyes, the eye with the smallest macular hole spontaneously closed.
Before the operation, the mean Snellen best corrected visual acuity (BCVA) was 20/210, or about 1/10th the normal visual acuity; the range was from 20/30 to 2/200. After the operations, the mean BCVA was 20/62 (range: 20/20 to 4/200). These statistics included all eyes (the 14 operated eyes and the three unoperated ones).
The authors concluded “Full-thickness MH can result from momentary exposure to high-power handheld laser devices. While spontaneous closure may occur in rare cases, most cases require early surgical intervention. Vitrectomy may be successful in closing the macular hole with visual acuity improvement in most of the cases.”
From the abstract of the study by Alsulaiman SM, et al., “Full-Thickness Macular Hole Secondary to High-Power Handheld Blue Laser: Natural History and Management Outcomes” in the American Journal of Ophthalmology, July 2015 Vol. 160, Issue 1, Pages 107-113.e1.
Note: Other studies have been published based on this data, an August 2013 LaserPointerSafety.com story about the first study is here.