June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
WIDE-FIELD FUNDUS AUTOFLUORESCENCE AND ELECTRORETINOGRAPHIC ABNORMALITIES IN PATIENTS WITH ACUTE ZONAL OCCULT OUTER RETINOPATHY
Author Affiliations & Notes
  • Amde Selassie Shifera
    Casey Eye Institute, Oregon Health & Science University, Portland, OR
  • Mark E Pennesi
    Casey Eye Institute, Oregon Health & Science University, Portland, OR
  • Paul Yang
    Casey Eye Institute, Oregon Health & Science University, Portland, OR
  • Phoebe Lin
    Casey Eye Institute, Oregon Health & Science University, Portland, OR
  • Footnotes
    Commercial Relationships Amde Selassie Shifera, AbbVie (F), Bristol-Myers-Squibb (F), Genentech (F), Institutional grant from Research to Prevent Blindness to the Casey Eye Institute (F); Mark Pennesi, Alcon Research Institute Young Investigator Grant (F), FFB Grant: CD-NMT-0914-0659-OHSU (F), NIH NEI K08: K08 EY021186 (F), RPB Grant: Career Development Award from Research to Prevent Blindness (F), Sucampo Pharmaceuticals (C); Paul Yang, CD-NMT-0714-0648-OHSU grant from Foundation Fighting Blindness (F); Phoebe Lin, AbbVie (F), Genentech (F), NIH award K08EY022948 (F), to Prevent Blindness Career Development Award (F)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 6183. doi:
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      Amde Selassie Shifera, Mark E Pennesi, Paul Yang, Phoebe Lin; WIDE-FIELD FUNDUS AUTOFLUORESCENCE AND ELECTRORETINOGRAPHIC ABNORMALITIES IN PATIENTS WITH ACUTE ZONAL OCCULT OUTER RETINOPATHY. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):6183.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

The purpose of this study is to describe the wide-field fundus autofluorescence (FAF) and electroretinographic changes in acute zonal occult outer retinopathy (AZOOR) in comparison with the results of optical coherence tomography (OCT) and perimetry.

 
Methods
 

We carried out a retrospective observational study on all patients seen by the authors from October 2012 to September 2014 who were diagnosed with AZOOR.

 
Results
 

There were 5 subjects and a total of 8 eyes in the study, with age at presentation ranging from 14 to 59 years. Two patients had unilateral involvement whereas 3 had bilateral disease. In one subject (1 eye), who presented 1 week after the onset of symptoms, the affected areas were hyperautofluorescent on FAF. In the other 4 subjects (7 eyes) who presented relatively late after the onset of symptoms, the affected areas were typically hypoautofluorescent on FAF with hyperautofluorescent borders or lesions seen at the edges. The FAF changes had a centrifugal spread in 6 eyes and both centripetal and centrifugal spreads in 2 eyes. In all eyes, FAF lesions corresponded well with the scotomata or isopter constrictions seen on perimetry. The affected areas, when accessible for OCT examination, exhibited outer retinal lamination disruptions in all affected eyes. In the 7 eyes that had multifocal ERG, there was evidence of regional abnormality of macular cone responses. Among the 7 eyes that had full-field ERG, 6 eyes showed evidence of cone-rod dysfunction while in 1 eye there were normal findings. The one eye that had normal full-field ERG showed abnormal macular cone responses on multifocal ERG. The abnormalities seen on ERG corresponded well with the changes seen on wide-field FAF in the affected eyes.

 
Conclusions
 

There was a good correlation between lesions seen on wide-field FAF and visual field or ERG changes. In subjects with peripheral retinal involvement, the peripheral lesions seen on wide-field FAF would have been missed on posterior pole FAF. Wide-field FAF in conjunction with OCT can be clinically useful in the initial evaluation and monitoring of AZOOR patients, and has the benefit of being quicker and more easily obtained than visual field tests and ERG.  

 
Fig. 1. Images from subject #2, right eye. A.Wide-field FAF. B.Multifocal ERG. C.OCT of the macula. D.Kinetic perimetry. E.Color fundus photo montage.
 
Fig. 1. Images from subject #2, right eye. A.Wide-field FAF. B.Multifocal ERG. C.OCT of the macula. D.Kinetic perimetry. E.Color fundus photo montage.

 
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