Courtesy of Robert H. Rosa, Jr, MD.). A, Clinical photograph (upper panel) and SD-OCT (lower panel) showing focal laser scar (arrowheads) and area of peripapillary atrophy (brackets). The double-headed arrow in upper panel indicates macular region scanned with SD-OCT. In lower panel, note the disruption of the outer plexiform layer, outer nuclear layer, ellipsoid zone, and RPE in the region of the focal laser scar. B, In light applications of laser photocoagulation, focal disruption and attenuation of the outer nuclear layer (asterisks), inner/outer segments, and RPE (arrowheads) may occur (H&E stain). C, In more intense laser applications, loss of the photoreceptor cell layer and RPE and closure of the choriocapillaris (right of arrow) may occur (H&E stain). Note the thin subretinal fibrosis (asterisk) in the laser scar. Variable RPE hypertrophy, hyperplasia, and migration into the retina (arrowhead), as well as breaks in Bruch membrane, can occur.