title: High-resolution optical coherence tomography findings in solar maculopathy and the differential diagnosis of outer retinal holes.
abstract: OBJECTIVE
  To characterize the morphology of outer retinal holes caused by solar maculopathy, using spectral-domain optical coherence tomography (SD-OCT).
  
  
  METHODS
  This study is an observational case series.
  
  
  METHODS
  The SD-OCT findings of 3 patients (6 eyes) with chronic solar maculopathy are presented.
  
  
  RESULTS
  SD-OCT demonstrates a characteristic appearance of partial-thickness hole(s) in the outer retina at the fovea. In 3 of 6 eyes, there is 1 hole directly beneath the umbo. In the remaining 3 eyes, there are multifocal holes spread across the fovea. Holes in more restricted layers, as had been previously reported with time-domain OCT, were not seen. In addition, advanced visualization of SD-OCT data demonstrates a hyperreflective ring around the outer retinal hole.
  
  
  CONCLUSIONS
  SD-OCT can be used diagnose solar maculopathy. In patients with central scotomas, characteristic outer retinal hole(s) without inner retinal cystic changes may prompt the clinician to uncover an undisclosed history of sungazing. Similar OCT findings can be caused by welder's maculopathy, tamoxifen retinopathy, juxtafoveal macular telangiectasia, foveolar vitreomacular traction, or, rarely, a closed macular hole, achromatopsia, alkyl nitrite abuse, acute retinal pigment epitheliitis, or Stargardt disease.
authors.affiliation: Massachusetts Eye & Ear Infirmary, Boston, Massachusetts. Electronic address: jason_comander_public@meei.harvard.edu.
authors.forename: Jason
authors.initials: J
authors.lastname: Comander
authors.affiliation: Massachusetts Eye & Ear Infirmary, Boston, Massachusetts.
authors.forename: Matthew
authors.initials: M
authors.lastname: Gardiner
authors.affiliation: Massachusetts Eye & Ear Infirmary, Boston, Massachusetts.
authors.forename: John
authors.initials: J
authors.lastname: Loewenstein
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000175:diagnosis* / Q000209:etiology; D012160:Retina / Q000473:pathology / Q000528:radiation effects*; D012167:Retinal Perforations / Q000175:diagnosis* / Q000209:etiology; D012559:Schizophrenia / Q000150:complications; D012607:Scotoma / Q000175:diagnosis; D013472:Sunlight / Q000009:adverse effects*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000528:radiation effects