Outer retinal structure in patients with acute zonal occult outer retinopathy

Marianna Mkrtchyan, Brandon Lujan, David Merino, Charles E. Thirkill, Austin Roorda, Jacque L. Duncan

Research output: Contribution to journalArticle

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Abstract

Purpose: To correlate visual function with high-resolution images of retinal structure using adaptive optics scanning laser ophthalmoscopy (AOSLO) in 4 patients with acute zonal occult outer retinopathy (AZOOR). Design: Observational case series. Methods: Four women, aged 18 to 51, with acute focal loss of visual field or visual acuity, photopsia, and minimal funduscopic changes were studied with best-corrected visual acuity (BCVA), Goldmann kinetic and automated perimetry and fundus-guided microperimetry, full-field and multifocal electroretinography (ffERG and mfERG), spectral-domain optical coherence tomography (SD-OCT), and AOSLO imaging. Cone spacing was measured in 4 eyes and compared with 27 age-similar normal eyes. Additional functional testing in 1 patient suggested that cones were absent but rods remained. Serum from all patients was analyzed for anti-retinal antibody activity. Results: In all patients vision loss was initially progressive, then stable. Symptoms were unilateral in 2 and bilateral but asymmetric in 2 patients. In each patient, loss of retinal function correlated with structural changes in the outer retina. AOSLO showed focal cone loss in most patients, although in 1 patient with central vision loss such change was absent. In another patient, structural and functional analyses suggested that cones had degenerated but rods remained. Anti-retinal antibody activity against a ∼45 kd antigen was detected in 1 of the patients; the other 3 patients showed no evidence of abnormal anti-retinal antibodies. Conclusions: Focal abnormalities of retinal structure correlated with vision loss in patients with AZOOR. High-resolution imaging can localize and demonstrate the extent of outer retinal abnormality in AZOOR patients.

Original languageEnglish (US)
JournalAmerican Journal of Ophthalmology
Volume153
Issue number4
DOIs
StatePublished - Apr 2012
Externally publishedYes

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Ophthalmoscopy
Anti-Idiotypic Antibodies
Lasers
Acute zonal occult outer retinopathy
Visual Acuity
Electroretinography
Visual Field Tests
Optical Coherence Tomography
Visual Fields
Retina
Antigens
Serum

ASJC Scopus subject areas

  • Ophthalmology

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Outer retinal structure in patients with acute zonal occult outer retinopathy. / Mkrtchyan, Marianna; Lujan, Brandon; Merino, David; Thirkill, Charles E.; Roorda, Austin; Duncan, Jacque L.

In: American Journal of Ophthalmology, Vol. 153, No. 4, 04.2012.

Research output: Contribution to journalArticle

Mkrtchyan, Marianna ; Lujan, Brandon ; Merino, David ; Thirkill, Charles E. ; Roorda, Austin ; Duncan, Jacque L. / Outer retinal structure in patients with acute zonal occult outer retinopathy. In: American Journal of Ophthalmology. 2012 ; Vol. 153, No. 4.
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