June 2013
Volume 54, Issue 15
ARVO Annual Meeting Abstract  |   June 2013
Acute zonal occult outer retinopathy: A new classification based on multimodal imaging
Author Affiliations & Notes
  • Samira Khan
    Ophthalmology, Northwestern Univeristy, Chicago, IL
  • Lee Jampol
    Ophthalmology, Northwestern Univeristy, Chicago, IL
  • Footnotes
    Commercial Relationships Samira Khan, None; Lee Jampol, Pfizer (C), Baxter International (C), Stem Cell Organization/Quintiles (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 5824. doi:
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      Samira Khan, Lee Jampol; Acute zonal occult outer retinopathy: A new classification based on multimodal imaging. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5824.

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

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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)  

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