Clinical features of phototoxic maculopathy due to screen use in the dark: A case series

Abstract

This study aimed to investigate the clinical manifestations of phototoxic maculopathy due to screen use in the dark. A retrospective case series was conducted, including individuals with phototoxic maculopathy due to screen use in the dark between January 2023 and March 2024 at the Eye Center, Renmin Hospital of Wuhan University. Data on best-corrected visual acuity, optical coherence tomography (OCT), OCT angiography, visual field testing, and multifocal electroretinography (mfERG) were collected and analyzed during follow-up. The study included 10 cases (mean age 41.1 ± 17.48 years) involving 13 eyes, comprising 6 males (8 eyes) and 4 females (5 eyes). Bilateral involvement was observed in 3 cases, unilateral right eye involvement in 5, and unilateral left eye involvement in 2. Individuals with unilateral or more severe involvement reported a habit of preferentially using the affected eye for mobile phone viewing. Among the involved eyes, 3 eyes from 3 cases developed choroidal neovascularization (CNV); 6 eyes from 5 cases exhibited disruption of the myoid, ellipsoid, and interdigitation zones; and 4 eyes from 3 cases presented with largely intact macular structure but impaired P1 wave response density on mfERG. Prolonged screen use in the dark may lead to phototoxic maculopathy, characterized by impaired macular function, structural disruption or loss of the photoreceptor layer, and in some cases, formation of CNV.

AI evidence extraction

Main findings

In this retrospective case series of 10 cases involving 13 eyes, prolonged screen use in the dark was associated with phototoxic maculopathy. Findings included choroidal neovascularization in 3 eyes, disruption of myoid, ellipsoid, and interdigitation zones in 6 eyes, and impaired P1 wave response density on mfERG despite largely intact macular structure in 4 eyes.

Outcomes measured

• best-corrected visual acuity
• optical coherence tomography findings
• optical coherence tomography angiography findings
• visual field testing
• multifocal electroretinography
• choroidal neovascularization
• macular structural disruption
• photoreceptor layer disruption or loss

Limitations

• Retrospective case series
• Small sample size
• Single-center study
• No control group stated

{
    "study_type": "case_report",
    "exposure": {
        "band": null,
        "source": "screen use in the dark; mobile phone viewing reported in unilateral or more severe cases",
        "frequency_mhz": null,
        "sar_wkg": null,
        "duration": "prolonged screen use in the dark"
    },
    "population": "Individuals with phototoxic maculopathy due to screen use in the dark treated at the Eye Center, Renmin Hospital of Wuhan University between January 2023 and March 2024",
    "sample_size": 10,
    "outcomes": [
        "best-corrected visual acuity",
        "optical coherence tomography findings",
        "optical coherence tomography angiography findings",
        "visual field testing",
        "multifocal electroretinography",
        "choroidal neovascularization",
        "macular structural disruption",
        "photoreceptor layer disruption or loss"
    ],
    "main_findings": "In this retrospective case series of 10 cases involving 13 eyes, prolonged screen use in the dark was associated with phototoxic maculopathy. Findings included choroidal neovascularization in 3 eyes, disruption of myoid, ellipsoid, and interdigitation zones in 6 eyes, and impaired P1 wave response density on mfERG despite largely intact macular structure in 4 eyes.",
    "effect_direction": "harm",
    "limitations": [
        "Retrospective case series",
        "Small sample size",
        "Single-center study",
        "No control group stated"
    ],
    "evidence_strength": "very_low",
    "confidence": 0.93000000000000004884981308350688777863979339599609375,
    "peer_reviewed_likely": "yes",
    "keywords": [
        "phototoxic maculopathy",
        "screen use in the dark",
        "mobile phone viewing",
        "macula",
        "optical coherence tomography",
        "OCT angiography",
        "multifocal electroretinography",
        "choroidal neovascularization"
    ],
    "suggested_hubs": []
}

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