Foveal choroidal neovascularization secondary to accidental laser exposure in a dermatologist A case report

Rationale: Most laser-induced retinal injuries are caused by accidental laser discharge during the preparation of laser devices without protective goggles, laser injury during the cosmetic procedure in a dermatologist, is very rare, with no prior case reports. Patient concerns: A 55-year-old Asian male dermatologist visited our hospital with a 2-week history of visual disturbance in his right eye. He had experienced sudden central scotoma in the right eye while using a Q-switched Nd: YAG laser (1064nm, 2J/cm(2), 6-mm spot size, 750ps) 2 to 3cm from the target without proper eye protection. He had applied a glass slide firmly onto the treatment area prior to commencing the procedure. The choroidal neovascularization (CNV) was detected via optical coherence tomography angiography (OCTA) 2 weeks after the laser injury. Diagnosis: Foveal CNV secondary to laser energy reflected from the glass slide. Intervention: Intravitreal bevacizumab (1.25mg/0.05mL) injection was performed. Outcomes: Regression of CNV was observed. Lessons: Retinal injury can occur not only by direct laser beam exposure but also by way of a beam reflected from a glass slide. Operators should always use laser safety eyewear during cosmetic procedures involving laser devices, so as to prevent the occurrence of ocular complications. Thorough short-term follow-up with OCTA is recommended for the prompt detection of CNV in cases of retinal laser injury.