Title

WELDING ARC MACULOPATHY: A CASE REPORT

Introduction

Photic retinopathy (PR) refers to a disorder caused by prolonged or high intensity exposure of the macula to light energy. It can occur after staring at the sun, at laser points and because of occupational hazards, such as in welding arc workers. This kind of light toxicity occurs due to a photochemical injury in which biochemical reactions cause destruction of the retinal tissue. It produces acute and chronic degenerative macular changes. Symptoms include blurry vision, central scotoma and metamorphopsia. They can be present within hours or even many months after the trigger event.

Methods

Medical records review

Results

A 51-year-old male patient was referred to us with the complaint of longstanding and progressive vision loss in his left eye. He was otherwise healthy and was not under any medications. Family history was negative for ocular diseases. He had been working as a welder for the past 10 years, sometimes without wearing proper protective devices. His best corrected visual acuity was 20/25 in his right eye (OR) and 20/40 in his left eye (OS). Ophthalmoscopy demonstrated areas of altered macular reflex in each eye, especially in the OS, as can be seen in the retinography. Autofluorescence: areas of macular hipoautofluorescence related to RPE atrophy, more proeminent in the OS. Fluorescein angiography showed staining corresponding to RPE disruption with no leakage. As the ocular findings were all chronic, we managed the case with clinical follow-up.

Discussion

PR is diagnosed based on clinical history, retinal examination and diagnostic imaging, such as OCT and FA. Recovery may be spontaneous in nature and can occur over the course of 3-6 months after the inciting event, though visual recovery might be incomplete and patient may suffer from permanent visual impairment and central scotoma. Thus, protective device containing appropriate lenses is essential to protect against retinal insult in welding laborers.

Keywords

- Photic maculopaty - Welding arc - Photochemical

Area

CLINICAL CASE

Authors

Rafael Garcia, Gabriella Marranghello Mingione, Andréia Novelli, Paulo Henrique Horizonte, Henrique Monteiro Leber, Nina Rosa Konichi Silva, Guilherme Daher G M Reis, André Marcelo V. Gomes