The goal of this retrospective observational study is to evaluate the effectiveness of retrobulbar glucocorticoid injection in patients with retinal photo-injury. The main questions it aims to answer are:
Does retrobulbar glucocorticoid injection improve visual outcomes in patients with retinal photo-injury? Does retrobulbar glucocorticoid injection promote recovery of retinal structural and microvascular changes assessed by optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA)? Patients with retinal photo-injury will be retrospectively identified and grouped according to the treatment they received. Clinical and ophthalmic data collected before treatment and during follow-up for up to 6 months will be reviewed, including best-corrected visual acuity (BCVA), fundus photography, spectral-domain OCT (SD-OCT), and OCTA. Visual and retinal imaging outcomes will be compared between the two groups to evaluate the potential effectiveness of retrobulbar glucocorticoid treatment.
The diagnosis was established based on a history of exposure to a high-intensity light source and clinical manifestations such as metamorphopsia and reduced visual acuity, combined with findings from fundus examination and OCT-specifically, disruption or defects in the photoreceptor inner/outer segment (IS/OS) junction and the retinal pigment epithelium (RPE) layer within the macular region.
Unable or unwilling to sign the informed consent form, or unable to adhere to study procedures.
Patients have conditions that significantly interfere with OCTA imaging, such as severe corneal opacity, cataracts, or vitreous hemorrhage.
Patients who develop other concurrent eye diseases or severe comorbidities requiring immediate treatment during the follow-up period-such as glaucoma, uveitis, scleritis, retinal detachment, optic neuritis, diabetic retinopathy, macular hole, retinal neovascularization, sclerosis, Parkinson's disease, or other disorders affecting the retina and optic nerve.
History of intraocular surgery or ocular trauma.
patients diagnosed with retinal photic injury
Case-control
Retrospective
retrobulbar injection of glucocorticoid
DrugRetrobulbar injection of Methylprednisolone （40mg/ml） once a week, or triamcinolone （40mg/ml） every 2-3 weeks, no more than 3 times in a row. For children, the dose should be halved or the interval extended, and closely watch for any side effects after injection.
Changes in Best-Corrected Visual Acuity (BCVA), measured in logMAR
Best-corrected visual acuity (BCVA) will be assessed using a standardized visual acuity chart after appropriate refractive correction and recorded as a decimal visual acuity value, which will be converted to the logarithm of the minimum angle of resolution (logMAR) for statistical analysis. BCVA will be assessed at baseline (before treatment) and at 1 week, 2 weeks, 1 month, 3 months, and 6 months after treatment. The BCVA value and the change from baseline at each follow-up time point will be summarized and compared. Lower logMAR values indicate better visual acuity.
Changes in Central Subfield Thickness, Ellipsoid Zone Defect Length, and Outer Nuclear Layer Thickness Measured by Optical Coherence Tomography
Retinal structural changes will be assessed using optical coherence tomography (OCT). The following quantitative parameters will be measured: central subfield thickness (CST, μm), maximum horizontal length of the ellipsoid zone (EZ) defect (μm), and foveal outer nuclear layer (ONL) thickness (μm). Measurements will be obtained at baseline (before treatment) and at 1 week, 2 weeks, 1 month, 3 months, and 6 months after treatment. Each parameter and its change from baseline at each follow-up time point will be summarized and compared to evaluate retinal structural recovery following treatment.
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