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R. F. Spaide, H. Koizumi, K. Freund; Photoreceptor Outer Segment Abnormalities as a Cause of Blind Spot Enlargement in Acute Zonal Occult Outer Retinopathy-Complex Diseases. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2863. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the correlation between visual field defects in diseases of the acute zonal occult outer retinopathy (AZOOR)-complex with their spectral domain optical coherence tomographic (OCT) findings.
Patients with AZOOR, multiple evanescent white dot syndrome (MEWDS), and multifocal choroiditis and panuveitis (MCP) examined in a private practice retinal referral center had threshold visual field testing. They also had spectral domain OCT examination performed using a device capable of obtaining a block of 128 b-scans in a 6 x 6 mm region centered on the optic nerve and macula. The areas of where defects in the boundary between the inner segments (IS) and the outer segments (OS) of the photoreceptors, termed the IS/OS boundary, were compared with the visual field defects measured.
There were 19 evaluable eyes among one patient with MEWDS, two with AZOOR, and 7 with MCP. In the 14 eyes with blind spot enlargement corresponding IS/OS boundary defects were found in the peripapillary region, while no IS/OS boundary defects were found in the 5 eyes without blind spot enlargement. IS/OS boundary defects also were seen over chorioretinal scars and areas of neovascularization. The IS/OS boundary defects around the nerve showed improvement, as did the blind spot enlargement, spontaneously in the patient with MEWDS and after treatment with immunosuppression in the patients with AZOOR.
The spectral domain OCT finding of IS/OS boundary defects, implicating photoreceptor outer segment perturbation, appears to explain the blind spot enlargement in patients with AZOOR-complex diseases. These defects are not necessarily permanent.
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