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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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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.
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.
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.
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.
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