[Accidental bilateral asymmetric ruby laser maculopathy].

Abstract

A 19-year-old man sustained a bilateral coagulation of the macula caused accidentally by a ruby laser rangefinder mounted on a tank. Five days later vision was OD 0.7, OS 0.05; there was a distinct disk of coagulation of the retinal pigment epithelium with clumping of melanin granula, more in the left eye than in the right, and subretinal hemorrhage on the left. Visual improvement corresponded to the asymmetric morphologic findings: Within two months visual acuity in the right eye recovered to 1.0. In the left eye there was a temporary increase to 0.3, then permanent deterioration of vision to 0.05 OS. The macula of the left eye showed massive lipofuscein aggregation in the subretinal space. Fluorescein angiography after two months showed some hyperfluorescence, more in the left than in the right eye, but no fluorescein extravasation. The vision in the left eye is still 0.05 one year after the accident.