Abstract
Purpose:
To classify acute zonal occult outer retinopathy (AZOOR) based on clinical course, funduscopic exam, autofluorescence (FAF) and spectral domain optical coherence tomography (SD-OCT) characteristics.
Methods:
Thirty two eyes of 22 patients with AZOOR were identified based on clinical course and funduscopic examination. 12 eyes had FAF and SD-OCT studies done.
Results:
Based on multimodal imaging, AZOOR can be classified as three types. Type 1 or primary AZOOR typically shows a peripapillary hypoautofluorescence with a ring of hyperautofluorescence surrounding the lesion. SD-OCT demonstrates loss of outer layers of the retina and typically spares the fovea. These features may stabilitize over many years. Type 2 or secondary AZOOR clinically presents as a multifocal choroiditis with localized or diffuse photoreceptor loss demonstrated on SD-OCT. Type 3 AZOOR initially shows a normal funduscopic exam with normal fovea with depressed photopic response on electroretinogram. This can progress to show pigmentary changes in the fovea and corresponding outer retinal abnormalities on SD-OCT.
Conclusions:
AZOOR can be classified as 3 types. FAF and SD-OCT may show altered fluorescence of the retinal pigment epithelium and a specific pattern of loss of photoreceptors in Type 1 AZOOR. Type 2 AZOOR is characterized by clinical evidence of multifocal choroiditis with secondary diffuse loss of photoreceptors. Type 3 AZOOR demonstrates clinical features of AZOOR with normal funduscopic examination and FAF. With progression, alteration of outer retinal layers may be noted on SD-OCT.
Keywords: 550 imaging/image analysis: clinical •
688 retina •
552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)