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Neurosensory retinal detachment of the macula in retinal phototoxicity documented by optical coherence tomography.

PURPOSE
To report a neurosensory detachment documented by optical coherence tomography in operating light microscope-induced retinal phototoxicity.


METHODS
A 53-year-old man had a pars plana lensectomy, core vitrectomy, and posterior chamber sutured intraocular lens implantation in his right eye. The surgery lasted >3 hours.


RESULTS
On postoperative Day 13, best-corrected visual acuity was 20/100. There was retinal pigment epithelial atrophy in the superior macula with subtle pigmentary clumping on its borders. Fluorescein angiography revealed staining in the area of retinal pigment epithelium atrophy with blockage of underlying choroidal fluorescence by the border hyperpigmentation in a pattern typical of phototoxicity. Optical coherence tomography documented a large, central neurosensory detachment. The central macular thickness was 731 μm. Best-corrected visual acuity in the right eye on postoperative Day 31 had improved to 20/60, and the optical coherence tomography had minimal subretinal fluid with a central macular thickness of 226 μm. On postoperative Day 78, there was no subretinal fluid, best-corrected visual acuity was 20/50, and the central macular thickness was 191 μm. Four months postoperatively, best-corrected visual acuity was 20/30.


CONCLUSION
Microscope light-induced retinal phototoxicity may be associated with a neurosensory detachment.