Case of laser induced maculopathy and treatment outcome after use of corticosteroids and lutein. : Case report of a patient with accidental laser induced retinal injury and treatment outcome.

Introduction:A 30yopatient presented sudden decrease of left vision and metamorphopsia after staring at a laser in a nightclub five days before.

Results:At presentation left visual acuitywas 6/18-2 unaided improving to 6/12-2 pinhole.Dilated fundoscopy showed a yellow-orange foveolar lesion in the left eye. OCT showed an alteration of foveal anatomy involving predominantly the outer retinal layers, hyper-reflective vertical band and large cystoid change at the inner retina. There was an increase of foveolar thickness to 397µ.Treatment was with oral corticosteroids (Prednisolone 0.5mg/ Kg).At one week left visual acuityimprovedto 6/12+2.There were hardly any cystic changes, with less hyper-reflective band and disruption at the outer layer.Lutein capsules 20 mg daily were added at one week. At three weeks patient reported vision back to normal - the left visual acuity was 6/6-2 unaided. OCT showed near-complete restoration of macular structure.

Conclusions: Positive clinical outcome with combined oral corticosteroids and lutein over a short period of time in a typical case – further review recommended of ideal treatment regimes for laser induced maculopathy.