Longitudinal Multimodal Imaging Findings Following Inadvertent 577 nm Laser Backscatter Exposure During Panretinal Laser Photocoagulation

Abstract

Purpose: To report an unusual case of retinal dysfunction in a treating ophthalmologist following inadvertent exposure to 577 nm yellow laser backscatter during panretinal photocoagulation. Methods: A single case was reviewed. Results: A 28-year-old physician was inadvertently exposed to 577 nm yellow laser backscatter while using an indirect ophthalmoscope to deliver panretinal laser photocoagulation for ischemic retinal disease. He immediately experienced bilateral after-images that persisted for 72 hours. Longitudinal multimodal retinal imaging revealed no structural abnormalities. Multifocal electroretinography (mfERG) performed soon after exposure demonstrated macular dysfunction in both eyes. At 18 months, mfERG amplitudes had normalized, but implicit times remained prolonged, consistent with persistent mild cone dysfunction. Conclusions: Inadvertent laser backscatter exposure can result in functional retinal changes without detectable structural abnormalities. This case underscores the importance of rigorous laser safety protocols for treating ophthalmologists during ophthalmic laser procedures.