Laser-Induced Maculopathy and Outcomes After Treatment With Corticosteroids and Lutein

This case report presents treatment outcomes for a patient with accidental laser-induced retinal injury. A 30-year-old man was evaluated for a sudden decrease of vision and metamorphopsia in his left eye after staring at a laser in a nightclub five days before presentation. Eye examination showed left visual acuity of 6/18-2 unaided, which improved to 6/12-2 on the pinhole test. Dilated fundoscopy showed a yellow-orange foveolar lesion in the left eye. Optic coherence tomography (OCT) showed an alteration of foveal anatomy predominantly involving the outer retinal layers, hyper-reflective vertical bands, and large cystoid change at the inner retina. Foveolar thickness was increased to 397 µ. Treatment was initiated with oral corticosteroids (prednisolone 0.5 mg/kg/day). At the one-week follow-up, left visual acuity improved to 6/12+2. Hardly any cystic changes were noted, with fewer hyper-reflective bands and less disruption at the outer layer. Treatment with prednisolone was continued and lutein capsules (20 mg/day) were added. At three weeks, the patient reported a return to normal vision, with left visual acuity of 6/6-2 unaided. On OCT, near-complete restoration of the macular structure was visualized. Although these results show positive clinical outcomes with combined oral corticosteroids and lutein over a short time for a typical case of laser-induced maculopathy, further review is recommended to determine the ideal treatment regimen.