title: 'Toy' laser macular burns in children: 12-month update.
abstract: OBJECTIVE
  There is increasing evidence that high-powered hand-held laser devices cause retinal injury. We present 12-month follow-up data for three patients that we previously reported with such retinal injuries.
  
  
  METHODS
  A retrospective case series of three children with maculopathy secondary to exposure to high-power hand-held laser devices. All children underwent clinical examination and spectral domain optical coherence tomography (SD-OCT) at presentation and follow-up. Fundus-controlled microperimetry was also undertaken 12-19 months after exposure.
  
  
  RESULTS
  Three children sustained macular injury after exposure to a high-powered hand-held laser. Acutely, they presented with a 'vitelliform-like' maculopathy with reduced vision. Over the course of follow-up, the best corrected Snellen acuity in all three patients improved to 'normal' levels (range 6/6-6/9). Long-term deficits in foveal retinal sensitivity were identified in two patients using fundus-controlled microperimetry. SD-OCT imaging showed persistent disruption of the foveal outer photoreceptor layers in all three children.
  
  
  CONCLUSIONS
  Although visual acuity improved over time, deficits in microperimetry and SD-OCT persisted. All three children had retinal pigment epithelium changes, requiring follow-up for longer-term sequelae of laser injuries such as expansion of retinal atrophy and development of choroidal neovascular membranes.
authors.affiliation: Department of Paediatric Ophthalmology and Strabismus, Moorfields Eye Hospital, London, UK.
authors.forename: N
authors.initials: N
authors.lastname: Raoof
authors.affiliation: Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Didcot, Oxfordshire, UK.
authors.forename: J
authors.initials: J
authors.lastname: O'Hagan
authors.affiliation: Consultant Ophthalmologist, Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.
authors.forename: N
authors.initials: N
authors.lastname: Pawlowska
authors.affiliation: Consultant Ophthalmologist, Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.
authors.forename: F
authors.initials: F
authors.lastname: Quhill
mesh_terms: D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D007834:Lasers / Q000009:adverse effects*; D008297:Male; D010988:Play and Playthings / Q000293:injuries*; D012160:Retina / Q000293:injuries*; D012164:Retinal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology