Early and Late Spectral Domain Optical Coherence Tomography Features of Acute Welding Maculopathy

Electrical welding arcs emit an intense and extended spectrum of radiation ranging from infrared to ultraviolet. The cornea and lens absorb the ultraviolet range giving rise to painful keratoconjuntivitis.1-3 Radiation in the visible and near infrared range (400-1400 nm wavelength) penetrates deep into the eye and, if sufficient in intensity, may damage the retina. Although welding induced photic retinal injury is rare, welders have a risk of phototoxic maculopathy. Infrared absorbing green glass filters placed within the welder’s helmet protects ocular tissues from welding arc radiation.4 Some reports have already described optical coherence tomography (OCT) features of acute or chronic welding maculopathy.5-8 Herein, we report early and late spectral domain OCT (SD-OCT) features in a case of bilateral welding maculopathy. A 25-year-old welder presented with visual blurring 3 days after arc welding. Past medical history was unremarkable. He had been exposed to welding arc light for a brief period of time, i.e. less than 30 seconds while using sunglasses, assuming that ordinary sunglasses are effective protection against welding light. Best corrected visual acuity was 5/10 in both eyes. The patient did not complain of ocular pain or injection. Dilated fundus examination revealed mild foveal pigmentary changes while other examinations were unremarkable. SD-OCT revealed a preserved foveal contour and normal vitreoretinal interface. A region of hyporeflectivity was evident disrupting the inner segment/outer segment (IS/OS) line. This hyporeflectivity had created cyst like spaces between the external limiting membrane and the retinal pigment epithelium (RPE) in the left eye (Figure 1).