Hindawi Publishing Corporation Case Reports in Ophthalmological Medicine Volume 2013, Article ID 906920, 5 pages http://dx.doi.org/10.1155/2013/906920 Case Report Solar Retinopathy: A Multimodal Analysis Claudia Bruè, 1 Cesare Mariotti, 1 Edoardo De Franco, 1 Yale Fisher, 2 Jacopo Maria Guidotti, 1 and Alfonso Giovannini 1 1 Ophthalmology Section, Department of Neuroscience, Polytechnic University of Marche, Via Brecce Bianche, 60121 Ancona, Italy 2 Vitreous-Retina-Macula Consultants of New York, 460 Park Avenue, 5th Floor, New York, NY 10022, USA Correspondence should be addressed to Claudia Bru` e; claudia.brue@gmail.com Received 17 December 2012; Accepted 6 January 2013 Academic Editors: J. F. Arevalo and T. Hayashi Copyright © 2013 Claudia Bru` e et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. Solar retinopathy is a rare clinical disturbance, for which spectral-domain optical coherence tomography (SD-OCT) indings are not always consistent. We report on two cases of solar retinopathy and discuss its diferential diagnosis. Methods. his is an observational case study. Results. A 12-year-old female was referred to ophthalmology for bilateral scotoma. Visual acuity was 20/50 in both eyes. Fundus examination was unremarkable, except for slight yellowish material in the central macula, bilaterally. SD-OCT revealed juxtafoveal microcystic cavities in the outer retina, interruption of the external limiting membrane and the inner and outer segment junctions, with disorganized material in the vitelliform space. Fundus autoluorescence showed hypoautoluorescence surrounded by a relatively hyperautoluorescent ring, bilaterally. Similar clinical and morphological indings were detected in a 27-year-old male. Conclusions. Solar retinopathy has a subtle presentation and patients oten deny sun-gazing. SD-OCT and fundus autoluorescence are noninvasive and useful tools for its diagnosis. 1. Introduction Solar retinopathy is a rare ocular lesion that can result from unprotected solar eclipse viewing and also from minimal gazing at the sun. he consequent photochemical/thermal retinal damage [1] oten has a subtle presentation, which can be misleading for its diagnosis. Spectral-domain optical coherence tomography (SD- OCT) is a noninvasive imaging technique that is useful for the detection of foveal impairment and to outline the location and extension of retinal injury from acute solar retinopathy [2]. However, acute solar retinopathy can some- times share biomicroscopic and SD-OCT foveal indings with pathologies such as whiplash injury, sunbed exposure, ocular trauma, the initial stages of an idiopathic macular hole, persistent retinal defects following successful macular hole repair, idiopathic parafoveal telangiectasis, and solitary macular cysts [3, 4]. Diferential diagnosis is oten handled according to patient history combined with OCT indings. Fundus autoluorescence (FAF) is a relatively new and noninvasive technique that is based on the autoluorescent properties of retinal luorophores, such as lipofuscin, which is mainly located in the retinal pigment epithelium (RPE). Reduced content of lipofuscin in the RPE has been described in cases of light-induced loss of photoreceptors [5]. A history of acute solar retinopathy in some cases is not reliable and luorescein angiography does not provide further informa- tion. Instead, SD-OCT provides a diagnostic aid for relevant indings, even if these are common to several retinal diseases. Furthermore, FAF represents an efective tool to detect subtle changes in the RPE and to provide a better understanding of the pathophysiology of solar retinopathy. We report here on the clinical, SD-OCT and FAF imaging indings from four eyes of two subjects with mild RPE damage following unprotected sun-gazing. 2. Case 1 A 12-year-old Caucasian female with blond hair and blue eyes complained about a sudden bilateral blurring in her central visual ield a few hours ater a long walk in the mountains on a sunny day. he patient denied any direct sun- gazing, wearing of a hat and sunglasses, use of systemic and