Target Sign Presentation of a Laser-Light–Induced Full-thickness Macular Hole
Introduction
A 15-year-old bilaterally phakic boy, while attending a dance show, looked directly with naked eyes into a green laser light having a wavelength of 532 nm and power of 100 mW. He looked at it about 3 times for about 10 seconds each time. Following this, he developed blurring of vision in the right eye. Two weeks later, he was found to have a best-corrected visual acuity of logMAR +1.0 in the affected right eye and logMAR +0.2 in the left eye. The Amsler grid showed a central scotoma. The color fundus photograph displayed a target sign at macula (Figure 1A). Fundus autofluorescence showed hyperautoflourescence at fovea with surrounding hypoautofluorescence (Figure 1B). There was a window defect at macula on fundus fluorescein angiography (Figure 1C). On swept-source optical coherence tomography, a stage 4 full-thickness macular hole with a base of 1,415 microns, height of 378 microns, and minimum linear diameter of 933 microns was seen (Figure 1D). It appears that the high-powered laser damaged the retinal layers, including the outer retina, leading to formation of a full-thickness macular hole. The harmful effects of green lasers from commercially available devices and the risks of intentionally gazing into them should be widely publicized.
(A) Color fundus photograph displaying a target sign at macula. (B) Fundus autofluorescence showing hyperautoflourescence at fovea with surrounding hypoautofluorescence. (C) Fundus fluorescein angiography showed window defect at macula. (D) Stage 4 full-thickness macular hole with complete posterior vitreous detachment.
