title: Macular injury by a military range finder.
abstract: OBJECTIVE
  The authors report the clinical findings of a civilian patient who unintentionally looked into the laser beam of a military range finder. Detailed information on the range finder is given. The objective is to illustrate the potential danger of such devices and to give detailed information on the device, the clinical findings associated with exposure, and the laser-tissue interaction mechanism.
  
  
  METHODS
  The patient was examined with fluorescein angiography, indocyanine green angiography, microperimetry, and optical coherence tomography, both in the acute stage (2 hours) and 4 weeks later. Fluorescein angiography was performed again 4 months later. A total of 100 mg prednisone tapered over 9 days was prescribed. Additionally, 50 microg tissue plasminogen activator (TPA) and 0.5 mL pure C2F6 were injected in the vitreous.
  
  
  RESULTS
  In the acute phase, hemorrhage was located beneath the retina, primarily beneath the retinal pigment epithelium. Retinal defects as seen initially over the subretinal blood were reduced after 4 weeks, but a retinal defect ranging from the lasered site toward the fovea remained. Visual acuity slightly increased from 20/100 to 20/63 after 4 weeks. Indocyanine green angiography showed a large hypofluorescent spot in the macula. Four months after the accident, a classic choroidal neovascularization developed, originating from the lasered site. The technical parameters of the range finder were: Nd:YAG laser (1,064 nm), pulse duration 10 ns, beam divergence 1.5 mrad, energy 10 mJ.
  
  
  CONCLUSIONS
  A range finder can produce severe macular injury. The primary laser-tissue interaction mechanism seems to be explosive disruption of choroidal tissue. Intravitreal injection of TPA and C2F6 did not show a clear benefit to such laser lesions. A late complication can be secondary choroidal neovascularization.
authors.affiliation: Department of Ophthalmology, University of Regensburg, Germany. johann.roider@klinik.uni-regensburg.de
authors.forename: J
authors.initials: J
authors.lastname: Roider
authors.forename: P
authors.initials: P
authors.lastname: Buesgen
authors.forename: H
authors.initials: H
authors.lastname: Hoerauf
authors.forename: U
authors.initials: U
authors.lastname: Schmidt-Erfurth
authors.forename: H
authors.initials: H
authors.lastname: Laqua
authors.forename: R
authors.initials: R
authors.lastname: Birngruber
mesh_terms: D000328:Adult; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005131:Eye Injuries / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005451:Fluorescein Angiography; D005466:Fluorocarbons / Q000627:therapeutic use; D005654:Fundus Oculi; D006801:Humans; D007208:Indocyanine Green; D007834:Lasers / Q000009:adverse effects*; D008266:Macula Lutea / Q000293:injuries* / Q000473:pathology; D008297:Male; D010960:Plasminogen Activators / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D014792:Visual Acuity
chemical_list: D005466:Fluorocarbons; C048381:perfluoroethane; D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator; D007208:Indocyanine Green; D011241:Prednisone