SCIENTIFIC POSTER

Welder’s Retinopathy Misdiagnosed as Age-related Macular Degeneration by Hyun Seung Yang, South Korea


ABSTRACT

Background & Objective:

Age-related macular degeneration (AMD) is the most common cause of blindness in developed countriey. However, photic retinal injury also can have characteristics similar to those of AMD, including drusen, retinal pigment epithelial changes, geographic atrophy, and accumulation of subretinal fluid or neovascularization. The high temperature of plasma arc welding results in the radiation of many electromagnetic waves and can cause photic retinal injury. However, the photic retinal injury associated with plasma arc welding have been reported rarely. This report describes cases of photic retinopathy induced by plasma arc welding in male patients who worked at an arc welding centre in a shipyard.

Methods & Results:

We here describe 5 relatively young male patients who were misdiagnosed as having wet AMD (wAMD) using fundus photo, spectral domain optical coherence tomography (OCT), and fluorescein angiography (FA). Their average age was 51.4 ± 5.1 years. Their average visual acuity was -0.17 ± 0.22 (logMAR) and intraocular pressure was 15.9 ±3.1 mmHg. Nine of the 10 eyes showed foveal changes in fundus examination. On OCT and FA, foveal mottling, yellow deposition, absence of definite choroidal neovascularization (CNV) or occult type CNV, filling at late phase, photoreceptor disruption, and sub-retinal pigment epithelium deposition with pigment epithelial detachment were observed. The mild accumulation of subretinal fluid appeared to resolve after anti-VEGF injection in most cases.

Conclusion:

The welder’s retinopathy was usually occurred to relatively young male, presented bilaterally, and good vision with characteristic spectral domain OCT and FA findings were observed, similar to the features of typical wAMD. When a 40- to 60-year-old man visits a clinic with symptoms suspected to indicate bilateral wAMD, present and past occupations should be investigated, as well as specific findings on OCT and FA. Spectral domain OCT findings described in this report may improve our understanding of the differences between wAMD and welder’s retinopathy. In addition, socio-structural safety regulations and provision of health education at arc welding centres should be ensured, with regular health check-ups, including ophthalmological examinations


CONTACT DETAILS

 

Hyun Seung Yang
Seoul Shinsegae Eye center
Eui Jung Bu, Gyeonggido
South Korea
Email : yangg961@gmail.com
Cell Phone: +821089663827
Work Phone: +821089663827