Acute Zonal Occult Outer Retinopathy (AZOOR): a case report of vision improvement after intravitreal injection of Ozurdex

Yi Chun Kuo,Rong Kung Tsai,Nancy Chen

doi:10.1186/s12886-017-0638-5

Yi Chun Kuo, Rong Kung Tsai + Show 1 more

Open Access

https://doi.org/10.1186/s12886-017-0638-5

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Abstract

BackgroundAZOOR was first described by Gass in 1993 as a syndrome with rapid loss of one or more extensive zones of the outer retinal segments. It is characterized by photopsia, minimal funduscopic changes, and electroretinographic abnormalities. The efficacy of systemic steroids in treating AZOOR has been previously described and advocated by the concept of autoimmune retinopathy. However, the use of intravitreal of sustained-released steroid had not been mentioned to date.Case presentationA 34-year-old man had sudden onset of central scotoma and photopsia in the left eye. His visual acuity continued deteriorating. The visual field defect demonstrated bilateral enlarged blind spots and altitudinal defects. Fluorescein angiography (FA) showed nonspecific retinal inflammation, and an electroretinogram (ERG) illustrated decreased amplitude of the b wave in both eyes. Optical coherence tomography (OCT) examinations revealed parafoveal loss of the photoreceptor inner/outer segment (IS/OS) junction. Therefore, acute zonal occult outer retinopathy (AZOOR) was diagnosed. Although his vision did not improve under the initial treatment of systemic corticosteroid and calcium channel blocker, remarkable improvement was noticed after the intravitreal injection(IVI) of Ozurdex, consistent with the recovered IS/OS junction disruption.ConclusionsWe herein report a typical case of AZOOR, suggesting that the intravitreal injection of steroid may benefit in certain patients.

Highlights

acute zonal occult outer retinopathy (AZOOR) was first described by Gass in 1993 as a syndrome with rapid loss of one or more extensive zones of the outer retinal segments
We report a typical case of AZOOR, suggesting that the intravitreal injection of steroid may benefit in certain patients
AZOOR was first described by Gass in 1993 as a syndrome with rapid loss of one or more extensive zones of the outer retinal segments

Summary

Introduction

AZOOR was first described by Gass in 1993 as a syndrome with rapid loss of one or more extensive zones of the outer retinal segments. Conclusions: We report a typical case of AZOOR, suggesting that the intravitreal injection of steroid may benefit in certain patients. Kuo et al BMC Ophthalmology (2017) 17:236 did not subside with oral steroid use; he experienced visual improvement after receiving intravitreal injection of a sustained-released steroid. Visual field (VF) examinations demonstrated bilateral enlarged blind spots and altitudinal defects (Fig. 1a-b).

Results

Conclusion