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Fuller DG. 
“Severe Solar Maculopathy Associated with the use of Lysergic Acid Diethylamide (LSD)”. 
Amer. J. Ophthalmol.. 1976;81(4):413-16.
Patients with solar maculopathy typically have a mild to moderate decrease in vision and usually evidence minor changes ophthalmoscopically in the foveal area. Severe macular involvement may occur with sun gazing, particularly when the sun exposure is related to the use of lysergic acid diethylamide LSD.

The association of solar maculopathy with hallucinogenic drugs is a recent observation. Ewald in 1971 reported nine Army enlisted men with macular damage incurred by sun gazing during LSD "trips" or during "flash back periods." Schatz and Mendelblatt reported two cases of LSD-related solar maculopathy in civilians in 1973. Schatz and Mendelblatt's patients had visual acuities of 20/30 or better in each eye when initially seen and had acuities of 20/20 bilaterally four months after the injury. Ewald did not report visual acuity. In 1975, von Domarus described a patient with solar maculopathy associated with LSD ingestion. Visual acuity improved from 20/50 and 20/35 initially to 20/20 in each eye during seven months of observation.

A case of severe solar maculopathy associated with LSD usage is reported. A 23-yr-old man was admitted with severe left ocular pain and bilateral blurred vision. The previous day he had taken a large dose of LSD and lain in the sun for 4 hr. 16 Hr after the injury 1st and 2nd degree sunburn was present on his face and chest. He had severe actinic keratoconjunctivitis of the left eye. Left eye-fundus was difficult to see due to corneal clouding but severe macular edema was seen. There was a 3 degree central scotoma in the right eye and a 12 degree one in the left eye. Retinal pigment epithelium mottling was evident and the left macula presented a 'bull's eye'-lesion. The patient was followed for 4 months and damage slowly improved. There was no true retinal hole. After 4 months there was still a dense 3 degree central scotoma in the left eye.

Treatment was with 60 mg p.o. prednisone daily within the first 24-hr, tapering over a 6-wk period. The left eye also had 3 subtenon's injections of corticosteroids.
Notes # : (Nur Ring-Doc Referat vorhanden)
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