Clinical analysis of 18 patients with acute zonal occult outer retinopathy

Abstract

[Objective] To observe the clinical features of acute zonal occult outer retinopathy (AZOOR).[Methods] Eighteen patients (18 eyes) with AZOOR were enrolled in this study.All the patients were examined for corrected visual acuity,fundus examination,visual field and electroretinography (ERG).For part of these patients,fluorescein angiography (FFA),optic coherence tomography (OCT),visual evoked potential (VEP) and multifocal ERG (mf-ERG) were performed.Clinical features wereobserved.Comparative analysis was performed on the electrophysiological Results between affected eyes and fellow eyes.The consistency of OCT,visual field and mf-ERG results was investigated.[Results]The patients included three males and 15 females.All patients were unilateral involved.16 eyes (88.9％) were myopia,two eyes (11.1％) were emmetropia.11 eyes (61.1％) have normal fundus; single yellow-white punctuate lesion or old RPE lesion near macular were found in three eyes (16.7％) ; depigmented zones in temporal retina were found in four eyes (22.2％).All central visual field results were abnormal,but peripheral visual field results were normal.OCT findings included irregularity,absence or breaks of the photoreceptor inner segment/outer segment (IS/OS) junction.Amplitudes of full-field ERG were reduced in the affected eyes (t=3.516,2.689,3.103,3.517,2.999,3.309;P＜0.05),and implicit times were delayedin most responses except for rod response (t1=1.023,P=0.306).Amplitudes of P100 wave of visual evoked potential were reduced statistically (t=2.04,P=0.041),but the differences of implicit times between the affected eyes and the fellow eyes were not statistically significant (t =1.687,P =0.092).Amplitude reduction of multifocal ERG existed in all affected eyes.Coincidence was found between results of OCT and mf-ERG.But abnormal zones found by central visual field did not always coincide with those by mf-ERG.[Conclusion]s The majority of patients who develop AZOOR are young women with myopia.Most patients have normal fundus.Central visual field and electrophysiological examinations are always abnormal.Irregularity,absence or breaks of the photoreceptor 1S/OS junction can be proved by OCT. Key words: Retinal diseases/ diagnosis; Electroretinography/utilization; Tomography, optical coherence/utilization