Functional and Anatomical Changes of Acute Solar Retinopathy Investigated With Electroretinography and Optical Coherence Tomography: A Case Report

The purpose of this case is to illustrate how early electroretinography (ERG) can be used to investigate functional macular changes caused by acute solar retinopathy. This is a case report of a 44-year-old woman who presented on April 12, 2024 with acute solar retinopathy after viewing the solar eclipse on April 8, 2024 without wearing solar viewing glasses. The patient's best corrected visual acuity (BCVA) was 20/800 OU. Yellow macular lesions were seen on fundoscopy bilaterally. Spectral domain optical coherence tomography (SD-OCT, Spectralis; Heidelberg Engineering, Heidelberg, Germany) revealed bilateral foveal hyperreflectivity of the outer retina with attenuation of the external limiting membrane, ellipsoid zone, and retinal pigment epithelium (RPE) interdigitation line. Early ERG was performed to determine retinal function. Full field ERG (ffERG) demonstrated normal generalized retinal function OU; however, multifocal ERG (mfERG) showed bilateral macular dysfunction primarily affecting the foveal and parafoveal regions. These findings persisted at the two-month follow-up with no significant improvement in the BCVA. Acute solar retinopathy presents with anatomical changes to the retinal layers, particularly photoreceptors. Damage and disruption to photoreceptors can result in consequent apoptosis and atrophy that can be seen on fundoscopy and OCT imaging. Measures of retinal function, such as ERG, can be used in determining baseline and progression of visual function. Additionally, this case illustrates the importance of public health measures to educate the general population about the dangers of sungazing.