Correlation of macular structure and function in a boy with primary foveomacular retinitis and sequence of changes over 5 years.
Doc Ophthalmol. 2017 Apr 27;:
Authors: Badhani A, Padhi TR, Panda GK, Mukherjee S, Das T, Jalali S
PURPOSE: To describe the clinical characteristics, macular structure and function, and to document sequential changes over 5 years in a 10-year-old boy with bilateral primary foveomacular retinitis.
METHODS: A 10-year-old boy presented with sudden onset scotoma in both eyes, experienced after getting up from bed on a non-eclipse day. He persistently denied direct sun-gazing. He neither had any significant systemic illness, nor was using any medications. In addition to a detailed examination at presentation that included fundus fluorescein angiogram (FFA), electroretinogram (ERG), pattern ERG and electrooculogram (EOG), he was examined periodically for 5 years with Humphrey visual field (HVF), spectral domain optical coherence tomogram (SDOCT), Amsler grid charting and multifocal ERG. The macular structure and functions were analyzed over the years and correlated with the symptoms.
RESULTS: All findings were bilaterally symmetrical at each visit. At presentation, his corrected visual acuity was 20/25 with subfoveal yellow dot similar to solar retinopathy, central scotoma with reduced foveal threshold in HVF 24-2, micropsia in Amsler grid, missing of two plates on Ishihara color vision chart, transfoveal full thickness hyper-reflective band on SD OCT, unremarkable FFA and normal foveal peak in mfERG. The flash ERG and EOG were unremarkable. A month later, his VA improved to 20/20, he had relative scotoma in Amsler grid, no scotoma in HVF (10-2), restoration of the inner segment of the photoreceptors with sharp defect involving ellipsoid and photoreceptor interdigitation zone in SDOCT and blunting of foveal peaks in mfERG. Three months later, his corrected VA was 20/20 with relative scotoma in Amsler grid, normal color vision, no scotoma in HVF 10-2 and unchanged SDOCT findings. In subsequent examinations at 6, 9, 14, 29, 39 and 60 months, he was symptomless with VA 20/20, unremarkable fundus, normal Amsler grid and HVF (normal foveal threshold), unchanged SDOCT findings and the reduced foveal peaks on mfERG in both eyes got normalized only at 60 months.
CONCLUSION: Presented here is a case of bilaterally symmetrical idiopathic foveomacular retinitis that had a clinical appearance similar to solar retinopathy. The fundus changes persisted for 4 weeks, the symptoms and changes in Amsler grid lasted for 3 months, and the foveal threshold in visual fields normalized within 3 months. Maximum change in the SDOCT defect occurred within a month, and the extrafoveal defect in the ellipsoid and photoreceptor interdigitation line persisted despite resolution of symptoms and resolution of the visual field defect and normal distance vision. Probably, the foveal lesion detected on SDOCT was too small to cause a reduction in the distance visual acuity or show up in the visual field and mfERG later.
PMID: 28451988 [PubMed - as supplied by publisher]
Backward-gazing method for measuring solar concentrators shape errors.
Appl Opt. 2017 Mar 01;56(7):2029-2037
Authors: Coquand M, Henault F, Caliot C
This paper describes a backward-gazing method for measuring the optomechanical errors of solar concentrating surfaces. It makes use of four cameras placed near the solar receiver and simultaneously recording images of the sun reflected by the optical surfaces. Simple data processing then allows reconstructing the slope and shape errors of the surfaces. The originality of the method is enforced by the use of generalized quad-cell formulas and approximate mathematical relations between the slope errors of the mirrors and their reflected wavefront in the case of sun-tracking heliostats at high-incidence angles. Numerical simulations demonstrate that the measurement accuracy is compliant with standard requirements of solar concentrating optics in the presence of noise or calibration errors. The method is suited to fine characterization of the optical and mechanical errors of heliostats and their facets, or to provide better control for real-time sun tracking.
PMID: 28248404 [PubMed - in process]
[A New Way to Look Up. Solar Retinopathy Risks and Methods of Prevention Prior to the 2015 Solar Eclipse].
Klin Monbl Augenheilkd. 2016 Sep 19;
Authors: Tsatsos M, MacGregor C, Gousia D, Moschos M, Detorakis E
A solar eclipse is an impressive natural phenomenon that was last experienced in Europe in 2006. Last year, on March 20th 2015, a solar eclipse was visible in much of Europe. Solar retinopathy is a recognised potentially sight threatening condition that has been associated with direct or unprotected sun gazing. Public education has been shown to improve behaviour and attitudes that could influence the development of solar retinopathy during an eclipse. We have performed a study through newspapers prior to the 2015 solar eclipse in different European countries, in order to determine the level of public health awareness and attitudes to protection. Methods: 31 online editions of national newspapers were reviewed from six countries where the eclipse was most visible. Solar retinopathy, potential warnings, safe methods of viewing an eclipse and assessment of use and dangers of modern technologies were assessed. Results: All 25 newspapers examined mentioned the solar eclipse and risk to eyesight. Safe methods for viewing the eclipse were discussed in all newspapers. Eclipse eyeglasses were mentioned in 29 of the 31 newspapers reviewed. Children were identified as a high-risk group but advice for children viewing the eclipse varied between countries. Conclusion: Since the solar eclipse of 2006, there has been an increase in the level of education available in the media. Although the safe methods for viewing an eclipse have not changed in recent years, emerging technologies, such as camera phones and the "selfie" trend, have potentially increased the risk of eclipse-associated retinopathy.
PMID: 27643600 [PubMed - as supplied by publisher]
[Unilateral Solar Maculopathy after Gazing at Solar Eclipse].
Klin Monbl Augenheilkd. 2016 Jun;233(6):749-52
Authors: Mehlan J, Linke SJ, Wagenfeld L, Steinberg J
A 43-year-old male patient with unilateral metamorphosia presented after gazing at an eclipse with only one eye. Damage of the macula was demonstrated funduscopically, with OCT and angiography. Six weeks after initial presentation and oral methylprednisolone therapy (40 mg/d for 10 days), the symptoms and the morphological changes decreased. Solar retinopathy is a photochemical alteration of the retina, usually seen after sun gazing. In younger patients, it mostly presents as bilateral solar maculopathy. Some patients exhibit partial or total recovery.
PMID: 27055491 [PubMed - in process]
Retinal vascular tortuosity in DiGeorge syndrome complicated by solar retinopathy.
Retin Cases Brief Rep. 2013;7(4):343-6
Authors: De Niro JE, Randhawa S, McDonald HR
PURPOSE: To report a case of vascular tortuosity associated with DiGeorge syndrome that was complicated by solar retinopathy.
METHODS: Case report and literature review.
RESULTS: A 56-year-old woman with DiGeorge syndrome with secondary schizophrenia and developmental delay presented with decreased vision that was worse in her left eye. Ocular examination revealed bilateral retinal vascular tortuosity involving both the arteries and veins. Both eyes had an abnormal foveal light reflex with a central yellowish hue, which was more pronounced in the left eye. Optical coherence tomography showed disruption of the photoreceptor inner segment-outer segment junction and retinal pigment epithelium centrally, which was also more prominent in the left eye.
CONCLUSION: DiGeorge syndrome is associated with retinal vascular tortuosity in a large percentage of patients. The patient's decreased vision is likely caused by solar retinopathy (prolonged sun gazing as a result of the secondary schizophrenia and developmental delay).
PMID: 25383826 [PubMed]
Solar retinopathy: a multimodal analysis.
Case Rep Ophthalmol Med. 2013;2013:906920
Authors: Bruè C, Mariotti C, De Franco E, Fisher Y, Guidotti JM, Giovannini A
Purpose. Solar retinopathy is a rare clinical disturbance, for which spectral-domain optical coherence tomography (SD-OCT) findings are not always consistent. We report on two cases of solar retinopathy and discuss its differential diagnosis. Methods. This is an observational case study. Results. A 12-year-old female was referred to ophthalmology for bilateral scotoma. Visual acuity was 20/50 in both eyes. Fundus examination was unremarkable, except for slight yellowish material in the central macula, bilaterally. SD-OCT revealed juxtafoveal microcystic cavities in the outer retina, interruption of the external limiting membrane and the inner and outer segment junctions, with disorganized material in the vitelliform space. Fundus autofluorescence showed hypoautofluorescence surrounded by a relatively hyperautofluorescent ring, bilaterally. Similar clinical and morphological findings were detected in a 27-year-old male. Conclusions. Solar retinopathy has a subtle presentation and patients often deny sun-gazing. SD-OCT and fundus autofluorescence are noninvasive and useful tools for its diagnosis.
PMID: 23476848 [PubMed]
Solar retinopathy secondary to sungazing.
BMJ Case Rep. 2013 Jan 25;2013:
Authors: Moran S, O'Donoghue E
A young woman presented with a 2-day history of bilateral central scotoma and metamorphopsia following an episode of direct sun-gazing lasting 1-2 min. On examination, visual acuity was reduced to 6/9 bilaterally. Fundal examination revealed discrete yellow lesions at both maculae consistent with solar burns. Optical coherence tomography revealed retinal pigment epithelial defects at both fovea, which improved over time. The patient was managed conservatively. There was full resolution of symptoms in the left eye; however, a central scotoma persisted in the right eye at follow-up 1 year later.
PMID: 23355595 [PubMed - indexed for MEDLINE]
Unusual optical coherence tomography and fundus autofluorescence findings of eclipse retinopathy.
Indian J Ophthalmol. 2012 Nov-Dec;60(6):561-3
Authors: Li KH, Chen SN, Hwang JF, Lin CJ
A 63-year-old female patient complained of dimness in the central field of vision in the left eye after viewing an annular partial eclipse without adequate eye protection on 22 July 2009. Fundoscopy showed a wrinkled macular surface. Fundus autofluorescence study revealed well-demarcated hyperautofluorescence at the fovea. Optical coherence tomography demonstrated tiny intraretinal cysts. Fluorescein angiography and indocyanine green angiography were unremarkable. Epimacular membrane developed in the following month with deteriorated vision. Vitrectomy, epiretinal membrane and internal limiting membrane peeling were performed. Vision was restored to 20/20 after the operation. Direct sun-gazing may damage the retinal structures resulting in macular inflammation and increased focal metabolism, which explains the hyperautofluorescence. It may also induce epimacular membrane. Fundus autofluorescence might represent a useful technique to detect subtle solar-induced injuries of the retina. The visual prognosis is favorable but prevention remains the mainstay of treatment. Public health education is mandatory in reducing visual morbidity.
PMID: 23202400 [PubMed - indexed for MEDLINE]
Optical radiation and the eyes with special emphasis on children.
Prog Biophys Mol Biol. 2011 Dec;107(3):389-92
Authors: Söderberg PG
The Sun is the most abundant source of optical radiation for the child eye. New hand-held visible lasers are a threat to the child eye. Some scientific data suggest that near infrared radiation may cause cumulative damage in the ocular lens. The child eye usually is exposed to ambient solar radiation, gazing at the horizon. Ambient Sun ultraviolet radiation (UVR) exposure to the child is complex due to atmospheric scattering and strong dependence on background reflection. Solar exposure causes biological damage, only by photochemical mechanisms. UVR exposure to a child eye is mainly a threat to the anterior segment of the eye, but also age dependently to the retina. Above threshold exposure to UVR, for short delay onset of damage, causes a toxic reaction on the surface of the eye, snow blindness, and cataract. Sub-threshold daily exposure to UVR over decades is associated with several ocular surface pathologies and eye lid cancer. Visible radiation is a threat to the retina. A single above threshold exposure, for short delay onset of damage to the retina causes immediate photochemical Type II retinal damage, Sun blindness. A single exposure of the retina to a very high intensity laser beam may cause thermal or thermo-mechanical damage in the retina. In environments with high irradiance of optical radiation, the child eye should be protected. Legislation and public information is required for avoidance of damage from high intensity laser systems. More research is urgently needed to exclude the potential hazard of near infrared radiation.
PMID: 21946042 [PubMed - indexed for MEDLINE]
Solar spectral lines ("solar halo")--healing or harmful for the retina?
Coll Antropol. 2010 Apr;34 Suppl 2:127-9
Authors: Vojniković B, Njirić S
The sungazing method has been known for thousands of years as healing method based on chromotherapeutic principle. Our examinations on the island of Rab show that it is acceptable only if applied 10 min before the sunset. Gazing has to be directed towards the green-yellow part of the spectrum, since the remaining part of the sun halo contains harmful energy. However, authors suggest that it would be preferable to use spectacles with medical filters transmitting wavelight of green-yellow colour, especially for treatment of macular degeneration.
PMID: 21302711 [PubMed - indexed for MEDLINE]
Frequency recognition in an SSVEP-based brain computer interface using empirical mode decomposition and refined generalized zero-crossing.
J Neurosci Methods. 2011 Mar 15;196(1):170-81
Authors: Wu CH, Chang HC, Lee PL, Li KS, Sie JJ, Sun CW, Yang CY, Li PH, Deng HT, Shyu KK
This paper presents an empirical mode decomposition (EMD) and refined generalized zero crossing (rGZC) approach to achieve frequency recognition in steady-stated visual evoked potential (SSVEP)-based brain computer interfaces (BCIs). Six light emitting diode (LED) flickers with high flickering rates (30, 31, 32, 33, 34, and 35 Hz) functioned as visual stimulators to induce the subjects' SSVEPs. EEG signals recorded in the Oz channel were segmented into data epochs (0.75 s). Each epoch was then decomposed into a series of oscillation components, representing fine-to-coarse information of the signal, called intrinsic mode functions (IMFs). The instantaneous frequencies in each IMF were calculated by refined generalized zero-crossing (rGZC). IMFs with mean instantaneous frequencies (f(GZC)) within 29.5 Hz and 35.5 Hz (i.e., 29.5≤f(GZC)≤35.5 Hz) were designated as SSVEP-related IMFs. Due to the time-locked and phase-locked characteristics of SSVEP, the induced SSVEPs had the same frequency as the gazing visual stimulator. The LED flicker that contributed the majority of the frequency content in SSVEP-related IMFs was chosen as the gaze target. This study tests the proposed system in five male subjects (mean age=25.4±2.07 y/o). Each subject attempted to activate four virtual commands by inputting a sequence of cursor commands on an LCD screen. The average information transfer rate (ITR) and accuracy were 36.99 bits/min and 84.63%. This study demonstrates that EMD is capable of extracting SSVEP data in SSVEP-based BCI system.
PMID: 21194547 [PubMed - indexed for MEDLINE]
Subtle solar retinopathy detected by fourier-domain optical coherence tomography.
J Chin Med Assoc. 2010 Jul;73(7):396-8
Authors: Kung YH, Wu TT, Sheu SJ
Solar retinopathy is a retinal injury caused by direct or indirect sun-gazing and solar eclipse observation without protection. Subtle changes in the retinal damage might not be evident on fundus photography and fluorescein angiography. A 40-year-old veteran suffered from paracentral scotoma in his left eye shortly after unprotected solar eclipse observation about 1 month earlier. His visual acuity was 6/5 in the right eye and 6/6 in the left. Anterior segments were normal bilaterally. Dilated fundus examination, fluorescein angiography, and central visual field testing did not reveal any abnormal findings. Fourier-domain optical coherence tomography was used for evaluation, and a focal defect in the inner and outer segments of the photoreceptor layer band was noted in the paracentral region of the fovea in the left eye, with central foveal thickness of 198 microm. Solar retinopathy is preventable with adequate eye protection. Education should be reinforced to the public. In mildly affected individuals with subtle retinal damage, Fourier-domain optical coherence tomography could be a useful imaging tool to detect the disease.
PMID: 20688308 [PubMed - indexed for MEDLINE]
Ocular manifestations of torture: solar retinopathy as a result of forced solar gazing.
Br J Ophthalmol. 2010 Oct;94(10):1406-7
Authors: Polat J, Feinberg E, Crosby SS
PMID: 20576780 [PubMed - indexed for MEDLINE]
[Solar retinopathy: follow-up examinations with optical coherence tomography (OCT) and microperimetry].
Klin Monbl Augenheilkd. 2007 Nov;224(11):862-6
Authors: Koinzer SO, Treumer F, Elsner H, Roider J
BACKGROUND: Solar retinopathy is a phototoxic damage to the central retina. It may cause visual deterioration and a central scotoma with reading difficulties, that usually fade with time. Morphological and functional changes can be very subtle and are often inadequately detected by standard examinations.
PATIENTS AND METHODS: The more affected, left eye of a 41-year-old female patient was examined clinically, by optical coherence tomography (OCT 3) and by MP 1-microperimetry during a 6-month follow up after gazing at a partial eclipse.
RESULTS: At all times visual acuity was reduced to 0.7 causing visual deterioration. OCT examinations showed a subfoveal damage of decreasing extent, which was still detectable after 6 months. The retinal affection resulted in a persistent microscotoma of decreasing depth.
CONCLUSION: OCT 3 and MP 1-microperimetry are able to detect the morphological and the functional damages in solar retinopathy at a level of sensitivity good enough to produce correlating results which allow the detection of subtle changes during follow-up.
PMID: 18034403 [PubMed - indexed for MEDLINE]
Foveomacular retinitis and associated optical coherence tomography findings.
Ophthalmic Surg Lasers Imaging. 2007 Jul-Aug;38(4):333-5
Authors: Topouzis F, Koskosas A, Pappas T, Anastasopoulos E, Raptou A, Psilas K
A 45-year-old man presented with clinical manifestations of foveomacular retinitis, including visual symptoms and foveal lesions characteristic of solar retinopathy, but repeated questions failed to elicit a history of sun gazing. Cross-sectional retinal images produced by optical coherence tomography revealed localized loss of retinal pigment epithelium cells in both eyes. A different pattern of reflectivity at the level of the photoreceptor layer was observed between the right and left eye, reflecting asymmetry in tissue damage. This case is described to provide additional evidence that solar retinopathy and foveomacular retinitis are the same entity and may also have common optical coherence tomography findings.
PMID: 17674927 [PubMed - indexed for MEDLINE]
[Did Leon Wyczókowski suffer from solar maculopathy?].
Klin Oczna. 2006;108(10-12):489-92
Authors: Kałuiny J, Markowski D, Kałuzny BJ, Sikorski B
Noted Polish painter, Leon Wyczółkowski, during his long-standing in Ukraine used to paint pictures gazing directly at the sun in order to intensify visual sensations. Damage to the eyes caused by sunlight induced him to become a patient of a famous ophthalmologist in Kiev. Past disease led to blue color vision impairment just like it happens to people who previously suffered from solar maculopathy. We suppose, it could gradually force the artist to resign from color painting and to take up drawing.
PMID: 17455734 [PubMed - indexed for MEDLINE]
[Optical coherence tomography follow-up of a case of solar maculopathy].
J Fr Ophtalmol. 2007 Mar;30(3):276-80
Authors: Macarez R, Vanimschoot M, Ocamica P, Kovalski JL
Solar maculopathy is caused by sun-gazing without protection and in most cases appears to be reversible. Retinal damage may be caused by photochemical changes combined with a rise in temperature at the time of sun observation. We report a case of bilateral solar retinopathy following direct sun gazing after observation of the partial eclipse on 3 October 2005. A 25-year-old Caucasian man presented 24 h after watching the eclipse with symptoms of blurred vision and a bright positive central scotoma. Total direct viewing time was approximately 5 min. While observing the eclipse, the patient kept both eyes open. On presentation, his visual acuity was 20/25 in his right eye and 20/32 in his left eye. Ophthalmoscopic examination revealed a bilateral yellowish-white spot in the center of the foveal region. Static visual field examination did not disclose any absolute scotoma but a decrease in the foveal threshold was noted in both eyes. Optical coherence tomography (OCT) examination revealed a bilateral increased reflectivity of the inner foveal retina that was greater in the left eye. This finding was associated with a hyporeflective area of the underlying retinal pigment epithelium: choriocapillaris complex and an increase in retinal thickness. Eight days later, visual acuity was 20/20 in each eye. Funduscopy showed the yellow lesion had vanished. Four months after exposure, funduscopy was normal and OCT scan showed normal reflectivity of all retinal layers in the fovea. However, static visual field examination disclosed a decreased foveal threshold on the left eye. We compare the OCT findings in this patient with the data reported in the literature. Indeed, various OCT findings have been reported depending on the intensity and frequency of sun exposure. This observation demonstrates that OCT appears to be potentially useful in the evolutive follow-up of solar maculopathy, and emphasizes the importance of eye safety during solar eclipse observation.
PMID: 17417154 [PubMed - indexed for MEDLINE]
Solar retinopathy and associated optical coherence tomography findings.
Clin Exp Optom. 2004 Nov;87(6):390-3
Authors: Chen JC, Lee LR
Solar retinopathy is a rare but well-recognised clinical entity of macular damage, caused by viewing a solar eclipse or direct sun-gazing. Visual deterioration from solar retinopathy typically ranges from 6/9 to 6/60 and in most cases the visual loss is reversible. We present a case of solar retinopathy following direct sun-gazing and illustrate the damage within the retinal structure with optical coherence tomographic (OCT) findings. The visual prognosis of solar retinopathy is usually favourable but prevention remains the mainstay of treatment. The optometrist may play an important role in patient education and reassurance, as well as differentiating solar retinopathy from other likely macular abnormalities.
PMID: 15575813 [PubMed - indexed for MEDLINE]
Solar retinopathy in Benin City, Nigeria.
West Afr J Med. 2003 Dec;22(4):356-7
Authors: Ukponmwan CU, Dawodu OA, Ayanru JO
The case reports of three patients who were seen at the University of Benin Teaching Hospital Benin City with a diagnosis of solar maculopathy are presented. There was good visual recovery in two of the patients. This report shows the effect on the retina of direct sun gazing. The need to use protective filters is emphasized.
PMID: 15008308 [PubMed - indexed for MEDLINE]
Optical coherence tomography of chronic solar retinopathy.
Am J Ophthalmol. 2004 Feb;137(2):351-4
Authors: Garg SJ, Martidis A, Nelson ML, Sivalingam A
PURPOSE: To describe the optical coherence tomographic findings in eight eyes of four patients with chronic solar retinopathy. All patients had a history of sun gazing months to years prior to presentation.
DESIGN: Retrospective case series.
METHODS: Patients were examined using biomicroscopy performed by two or more experienced vitreoretinal specialists. All eight eyes had optical coherence tomography performed at the time of initial examination.
RESULTS: All patients had a history of sun gazing and decreased vision in both eyes. On biomicroscopy, all eyes had a small, irregularly-shaped lamellar defect in the foveal center. No posterior vitreous detachment was present in any eye. Optical coherence tomography revealed a hyporeflective space at the level of the outer neurosensory retina and retinal pigment epithelium in all eyes.
CONCLUSION: Optical coherence tomography demonstrates a characteristic hyporeflective space in the outer retina in patients with chronic solar retinopathy. These findings correlate with the histopathology of this condition and may be a useful clinical tool in confirming its diagnosis.
PMID: 14962431 [PubMed - indexed for MEDLINE]
Benign "setting sun" phenomenon in full-term infants.
J Child Neurol. 2003 Jun;18(6):424-5
Authors: Yoshikawa H
I report two normally developed infants showing benign" setting sun" phenomenon. A 2(2-12)-year-old boy and a 7-year-old boy, who were born without any complications at full term, developed brief episodes of downward gazing during sucking and crying after birth However, there were no other clinical or laboratory findings, and they developed normally. The phenomenon was not visible until 6 months and 7 months, respectively. The "setting sun" phenomenon usually indicates underlying severe brain damage and can also be seen, although rarely, in healthy full-term infants until 1 to 5 months. However, the benign "setting sun" phenomenon might exist until 6 or 7 months of age in normal infants.
PMID: 12886979 [PubMed - indexed for MEDLINE]
Foveal spot: a report of thirteen patients.
Retina. 2003 Jun;23(3):348-53
Authors: Douglas RS, Duncan J, Brucker A, Prenner JL, Brucker AJ
PURPOSE: To describe the natural history of a series of patients with a small foveal or juxtafoveal red lesion.
METHODS: Retrospective chart review of 13 patients with a small foveal or juxtafoveal red spot. Long-term follow-up examination was obtained in seven patients.
RESULTS: Thirteen patients with a mean age of 34.6 years are reported. Initial visual complaints ranged from no complaints to mild blurring and central distortion of vision. None of the patients had a history of sun gazing or known macular disease. Eleven of the 13 patients had best-corrected visual acuities in the involved eye that were better than 20/30. The lesions were bilateral in five patients and unilateral in eight. When performed, optical coherence tomography and fluorescein angiography were unremarkable. Follow-up was obtained in seven patients (mean, 58 months), and visual acuity remained stable in all affected eyes. In all patients, the lesions remained stable without expansion or alteration of the foveal appearance over the course of follow-up.
CONCLUSIONS: This report identifies a foveal or juxtafoveal, irregular, apparently intraretinal, red lesion of unclear cause. Long-term follow-up of these patients has demonstrated stable visual acuity and lesion appearance.
PMID: 12824835 [PubMed - indexed for MEDLINE]
Ocular surface changes and tear film alterations associated with sun gazing during a solar eclipse.
Wien Klin Wochenschr. 2003 Jan 31;115(1-2):47-52
Authors: Nepp J, Dorner GT, Jandrasits K, Maar N, Schild G, Wedrich A
PURPOSE: A solar eclipse occurred in central Europe on August 11th, 1999. Following the eclipse, patients with ocular symptoms were investigated. Gazing at the sun without protection is liable to damage the retina. Our attention was focused on changes of the ocular surface and the tear film.
METHODS: Forty-three patients were investigated within one week after the solar eclipse as baseline. 33 of them were followed up one year later. Visual acuity and the central visual-field were measured, and the ocular surface and the fundus were examined using a slit lamp. The quality of the lacrimal tear film was examined using Schirmer's test for the aqueous layer, break-up time for the mucous layer and interference observation for the lipid layer, measured by a slit lamp and a tearoscope.
RESULTS: At the baseline 19 patients had non-specific visual problems. Pathological alterations of the tear film were seen in all three tear-film layers: Schirmer's test was pathological in 87%, break-up time decreased in 85%, the interference pattern of the lipid layer changed in 67% and there were changes in 87% using the tearoscope. One year later the non specific visual disorders had disappeared. Schirmer's test did not reveal much change from the baseline: 51% pathological, 24% remained pathological in break-up-time and the lipid layer was normalized except in 9%. Using the tearoscope, lipids were better than grade 3 in all patients.
CONCLUSION: After gazing at a solar eclipse the ocular surface and tear film changed. While the aqueous layer remained pathological in many patients, the lipid layer and the mucous layer recovered spontaneously.
PMID: 12658911 [PubMed - indexed for MEDLINE]
Exposure to a solar eclipse causes neuronal death in the retina.
Graefes Arch Clin Exp Ophthalmol. 2001 Oct;239(10):794-800
Authors: Thanos S, Heiduschka P, Romann I
BACKGROUND: A solar eclipse was observed in Europe on 11 August 1999. Several individuals suffered from transient or persisting retinal damage, caused by gazing at the eclipse without adequate eye protection. Retinal damage is the most serious hazard of exposure to light. but the mechanisms by which this type of exposure produces retinal damage and its cellular correlates are not yet established. We used an animal model to monitor the mechanisms of retinal damage following excessive light exposure, and in particular to study whether observation of the eclipse induces death of retinal cells.
METHODS: In the geographic area where the experiment was conducted, a partial (90%) solar eclipse was observed. Experimental albino rats were exposed to these eclipse conditions, and control rats were exposed to normal sunlight. Another group of control animals was exposed to the same conditions, but was provided with protective light filters of the type recommended for human use. The DNA fragmentation in retinal sections of the various groups was analysed by terminal deoxynucleotidyl-transferase-mediated dUTP nick-end labelling. This analysis revealed that exposure to both normal sunlight and to the eclipse resulted in neuronal apoptosis. Immunohistochemical techniques were used to evaluate possible glial-vascular alterations.
RESULTS: Dying cells could first be detected 24 h after exposure, the largest number of which were found 6 days later in the photoreceptor layer. Control levels were attained 14 days after the exposure. Retinal ganglion cells underwent apoptosis in both groups (normal sunlight and eclipse exposure), whereas in the neuroglial cells there was an up-regulation of the intermediate filament content. The number of dying cells in both groups was greater in animals whose pupils had been dilated pharmacologically during exposure. On the other hand, the protective filters were effective in preserving the rat retinal cells from apoptosis.
CONCLUSIONS: These results show, for the first time, that the cellular correlates of solar retinopathy are neuronal apoptosis accompanied by glio-vascular responses. Cellular apoptosis is an irreversible process, which could manifest itself as permanent visual impairment. The activation of non-neuronal cells, such as glial and endothelial cells, could be responsible for the more transient clinical symptoms.
PMID: 11760043 [PubMed - indexed for MEDLINE]
[Solar retinopathy acquired after gazing at the sun during prayers].
Bull Soc Belge Ophtalmol. 2000;275:41-5
Authors: Mwanza JC, Kayembe DL, Kaimbo DK, Kabasele PM, Ngoy DK
The authors present the results of a study based on six persons who developed retinopathy after gazing at the sun during prayers. Risk factors were studied and the prognosis evaluated. The mean follow-up time was 82 days. Risk factors were present in all patients. The visual acuity was reduced in all patients at first presentation and total improvement was noted in four of them. Of all six patients, only one had his ocular fundus normalized. Amsler's grid testing revealed in all patients bilateral central scotomas which persisted in four of them. Fluorescein retinal angiography, which was found to be abnormal in all cases, became normal in only one case. However, all patients continued to complain of visual disability because of the persistence of photophobia, meta-morphopsia and scotomas. In conclusion, the prognosis of solar retinopathy is variable and the recovery of visual acuity does not necessarily imply the improvement of vision. Appropriate eye protection such as solar filters must be used when gazing at the sun to protect from retinal damage.
PMID: 10853306 [PubMed - indexed for MEDLINE]
Solar retinopathy: a case report.
Zhonghua Yi Xue Za Zhi (Taipei). 1999 Dec;62(12):886-90
Authors: Yeh LK, Yang CS, Lee FL, Hsu WM, Liu JH
Sun-gazing is the main cause of solar retinopathy. A 20-year-old inebriated man lying in a park gazed at the sun for approximately three hours at noon. Forty-eight hours after sun-gazing, the patient experienced the symptoms of blurred vision, erythropsia, and central scotoma in the left eye. Visual acuity decreased from 6/6 to 6/60 in the left eye and fundi examinations showed a round, yellowish-white discoid lesion on the left fovea and a smaller one on the right fovea. Fluorescein angiography showed early dye leakage in the fovea of the left eye, that increased gradually in size and became fuzzy at the foveal border in the late phase. A small, central scotoma of the left eye was also found in the visual field test. One month later, the lesion in the fovea of the left eye became smaller and was surrounded by a coarse pigmented halo. Fluorescein angiography showed a window defect in the retinal pigment epithelium. Visual field testing disclosed that the central scotoma persisted, but became smaller. Six months after sun-gazing, a lamellar hole in the fovea of the left eye was detected by optical coherence tomography. The visual acuity was 6/6 in the right eye and 6/60 in the left eye, and was unchanged at the end of the six-month follow-up period.
PMID: 10634003 [PubMed - indexed for MEDLINE]
Solar retinopathy. A study from Nepal and from Germany.
Doc Ophthalmol. 1998;95(2):99-108
Authors: Rai N, Thuladar L, Brandt F, Arden GB, Berninger TA
319 patients with a solar retinopathy were seen in an eye clinic in Nepal within 20 months. All patients had either a positive history of sun-gazing or typical circumscribed scars in the foveal area. In more than 80% of the patients the visual acuity was 6/12 or better and did not deteriorate over time. 126 (40%) patients had a history of gazing at the sun during an eclipse, 33 (10%) were sun worshipers and 4 (1%) were in both categories. Three years later 29 patients were re-examined in a follow-up study. Only 16 had had visual disturbances directly after they had gazed into the sun. No colour vision defects were seen in any of the 44 affected eyes, when tested with Panel D 15, while four patients (6 eyes) had some uncertainty with the tritan plates of the Ishihara test charts. Metamorphopsia were recorded in 11 eyes. Five German patients with solar retinopathy were examined in more detail. Colour contrast sensitivity (CCS) was tested for the central and the peripheral visual field. CCS for tritan axis was raised in all patients for the central visual field, while it was normal for the peripheral visual field.
PMID: 10431794 [PubMed - indexed for MEDLINE]
Observation of head-shaking nystagmus with an infrared Frenzel's glass.
Acta Otolaryngol Suppl. 1995;519:191-2
Authors: Yuen K, Fujimoto M, Masuda Y
It has been reported that a head-shaking test is very useful in clinical practice. To observe head-shaking nystagmus (HSN) a Frenzel's glass and electronystagmography (ENG) have been used. Although observation with Frenzel's glass is a simple method, it tends to suppress after shaking nystagmus, as gazing is not completely eliminated with Frenzel's glass. An electronystagmogram in darkness can eliminate gazing completely, but it requires much trouble in routine use. We therefore tried to use Frenzel's glass with an infrared CCD camera. We observed highly provoked HSN like ENG in darkness and were able to use it without difficulty. We recognized the second phase in several cases with only an infrared Frenzel's glass and the rotatory component of the nystagmus. This method is more convenient and valuable for clinical use than ENG and Frenzel's glass.
PMID: 7610864 [PubMed - indexed for MEDLINE]
Reflex epilepsies: experience in Sri Lanka.
Ceylon Med J. 1994 Jun;39(2):67-74
Authors: Senanayake N
Reflex epilepsy (RE) is characterised by seizures that are regularly elicited by some specific stimulus or event mediated by neural pathways. In a prospective study of 1287 epileptic patients seen at Peradeniya, 223 (17.3%) were found to have RE, eating being the commonest stimulus (191 patients, 85.7%). Photosensitive epilepsy (PSE) was relatively rare. Intermittent photic stimulation on 874 unselected epileptic patients produced a positive photoconvulsive response in 60 (6.9%). None had photosensitive seizures, but 3 had a higher frequency of seizures while watching television. Eating epilepsy (EE) had the highest prevalence at Peradeniya (148/1000 epileptic patients). This group was male predominant, and the onset of epilepsy in most cases was in the second decade. The majority experienced partial complex seizures. Repetitive and chronic stimulation of the amygdala during eating is suggested as the mechanism underlying EE. Twenty-one patients had seizures evoked by calculation, problem solving or spatial tasks. Juvenile myoclonic epilepsy was the commonest form of seizure disorder in them. Although PSE itself is rare, self-induced epilepsy (SIE) was common. There were 8 patients who self-induced seizures. The majority were photosensitive and they induced seizures by gazing at the sun and waving a hand in front of the eyes. In the management of REs, clobazam produced impressive results. As for possible seizure-inhibitory mechanisms, our studies on a "Sathi" mediator showed definite EEG changes during mediation. Can mediation increase the seizure-threshold and abort or prevent the propagation of the epileptic discharge? The answer, apart from its possible therapeutic applications, may provide insight into the mechanisms of seizure generation.
PMID: 7923453 [PubMed - indexed for MEDLINE]
Abnormal electroretinography in schizophrenic patients with a history of sun gazing.
Authors: Gerbaldo H, Thaker G, Tittel PG, Layne-Gedge J, Moran M, Demisch L
Electroretinographic (ERG) measurements were performed in 9 schizophrenic patients and in 13 control subjects. The measurements of schizophrenic patients as a group did not differ from those of normals. However, 6 schizophrenic patients who had a past history of sun gazing showed a decrease in retinal responsiveness under conditions of light adaptation. These results suggest that a subgroup of schizophrenic patients, who show deviant light-related behavior, have abnormal ERG. We postulate that an abnormality in retinal dopaminergic neurons, which are known to reduce light responsiveness of horizontal and ganglion cells, is the underlying pathophysiology of this clinical finding.
PMID: 1625783 [PubMed - indexed for MEDLINE]
Photophilic and photophobic behaviour in patients with schizophrenia and depression.
Can J Psychiatry. 1991 Nov;36(9):677-9
Authors: Gerbaldo H, Thaker G
The authors interviewed 32 patients (25 with an RDC diagnosis of schizophrenia and seven with schizoaffective disorder) consecutively admitted to a psychiatric outpatient clinic. Ten patients had a history of photophilic behaviour with sun-gazing, while 20 patients showed no unusual behaviour related to light. Two patients who had depressive symptoms at the time of interview had a history of photophobic behaviour. Sixteen patients and 12 controls were tested for their threshold for discomfort of high intensity light; the thresholds were significantly higher in the patients with schizophrenia (especially in those with history of sun gazing). The implications of these findings for clinical practice and research are discussed.
PMID: 1773404 [PubMed - indexed for MEDLINE]
Lijec Vjesn. 1989 Nov;111(11):390-2
Authors: Ivanisević M, Stanić R
The paper presents three cases of photosolar maculopathy which point to possibility of visual impairment as a result of sun gazing due to the religious reasons. In all cases irreversibile visual impairment with permanent central scotoma had developed. Sun gazing is dangerous regardless of motives, and the only way to prevent photosolar maculopathy is to avoid sun gazing.
PMID: 2636294 [PubMed - indexed for MEDLINE]
Solar retinopathy following religious rituals.
Br J Ophthalmol. 1988 Dec;72(12):931-4
Authors: Hope-Ross M, Travers S, Mooney D
Four cases of solar retinopathy due to sun gazing during religious rituals are reported. All four patients suffered irreversible visual loss.
PMID: 3228548 [PubMed - indexed for MEDLINE]
Solar radiation and age-related macular degeneration.
Surv Ophthalmol. 1988 Jan-Feb;32(4):252-69
Authors: Young RW
Age-related macular degeneration (AMD) involves a progressive impairment of the outer layers in the center of the retina. Experimental studies have demonstrated that bright light preferentially damages precisely the region that degenerates in AMD. The evidence that solar radiation is responsible for some of the deteriorative changes that lead to AMD is examined in this review. In the primate eye, the high-energy portion of the solar spectrum is most hazardous to retinal molecules, with damaging effects increasing as photon energy rises. This action spectrum is explicable by the quantum laws which describe the interaction of radiation with matter. High-energy visible and ultraviolet photons can produce molecular damage by a photochemical mechanism. The lesion is exacerbated by oxygen, which initiates free-radical chain reactions (photodynamic effects). Melanin exerts a protective effect against damage from sunlight. In the human retina, documented lesions from solar radiation range from the acute effects of sun-gazing to injuries resulting from prolonged periods of exposure in brightly illuminated environments. The damage occurs in the same region that degenerates in AMD. A cataractous lens and ocular melanin both protect the retina against AMD, as predicted by the radiation hypothesis. Identification of an environmental factor that evidently plays a role in the etiology of AMD provides the basis for a program of preventive medicine.
PMID: 3279560 [PubMed - indexed for MEDLINE]
Br J Ophthalmol. 1986 Nov;70(11):816-8
Authors: Kuming BS
A group of patients is described who developed the clinical features of foveomacular retinitis. No causative factors were isolated, and all patients strongly denied any type of sun gazing. It is possible that there is a group of patients who have the features of foveomacular retinitis but have not had any direct exposure to the sun. These patients would then constitute a primary type of foveomacular retinitis, as opposed to a secondary type which has a known cause and is synonymous with solar retinopathy.
PMID: 3790482 [PubMed - indexed for MEDLINE]
Cicatricial ectropion due to essential skin shrinkage: treatment with rotational upper-lid pedicle flaps.
Can J Ophthalmol. 1983 Oct;18(6):269-73
Authors: Hurwitz JJ, Lichter M, Rodgers J
Ectropion is sometimes due to a shortage of skin of the lower lid (cicatricial) and may result from previous surgery, trauma, burns, skin diseases etc. Excessive exposure to the sun has also been incriminated. Vertical traction lines in the skin of the lower lid, accentuated by gazing up or by opening the mouth, suggest this condition. This paper describes the use of pedicle skin flaps rotated from the upper lid to treat cicatricial ectropion occurring in the absence of any predisposing factor and not responding to conservative treatment--that is, due to essential skin shrinkage. All 10 patients had an improved appearance, and epiphora persisted in only 1 patient, who subsequently underwent a punctum-enlarging procedure. In an 11th patient there was insufficient redundant upper-lid skin, so a free skin graft was used instead.
PMID: 6652570 [PubMed - indexed for MEDLINE]
Severe solar maculopathy associated with the use of lysergic acid diethylamide (LSD).
Am J Ophthalmol. 1976 Apr;81(4):413-6
Authors: Fuller DG
A 23-year-old man sustained severe macular damage by sun gazing during a hallucinogenic drug-induced state. Sequential fundus photography and fluorescein angiography documented prominent focal injury to the retinal pigment epithelium.
PMID: 1266919 [PubMed - indexed for MEDLINE]
Ann Ophthalmol. 1976 Mar;8(3):304-6
Authors: Galainena ML
Two cases of solar retinopathy following prolonged sun gazing are presented. Both patients were seen within an interval of 11 months, both with the diagnosis of schizophrenia paranoid type. These patients gave a history of sun gazing while praying to God, resulting in pigmentary disturbances of the macula, characterized by central and parafoveal depigmentation with perifoveal hyperpigmentation, as well as permanent impairment of vision in both eyes.
PMID: 1267309 [PubMed - indexed for MEDLINE]
Foveomacular retinitis: report of cases in three young females.
Ann Ophthalmol. 1975 Aug;7(8):1035-8
Authors: Woldoff HS, Kilpatrick WR
Cases of foveomacular retinitis in three young females (4 eyes) are presented. No history of sun gazing was given; all returned to normal or near normal acuity following resolution of the natural course of the disease. The various proposed etiologies and abnormal findings are discussed.
PMID: 1180459 [PubMed - indexed for MEDLINE]
Can Med Assoc J. 1963 Jul 20;89:134-5
Authors: SHIRLEY SY
Retinal burns can be produced by direct gazing at the sun. This lesion is caused by the thermal effects of the visible and near infrared rays focused on the pigment structure behind the retina. It is rarely seen, as the normal eye will tolerate only fleeting glances at the sun, but is fairly common during a solar eclipse. A case of solar retinitis is presented in which treatment with corticosteroids lessened the retinal edema but the patient suffered a bilateral central scotoma and vision reduced to the 20/40 level. In viewing a solar eclipse a No. 4 density filter is recommended; as a rough test this filter will abolish the readability of print on a 60-watt incandescent frosted electric light bulb.
PMID: 13977409 [PubMed - indexed for MEDLINE]