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. 2014:2014:290696.
doi: 10.1155/2014/290696. Epub 2014 Jul 21.

Acute zonal occult outer retinopathy with atypical findings

Dimitrios Karagiannis  1 , Georgios A Kontadakis  1 , Artemios S Kandarakis  1 , Nikolaos Markomichelakis  2 , Ilias Georgalas  2 , Efstratios A Parikakis  1 , Stamatina A Kabanarou  3
Affiliations

Acute zonal occult outer retinopathy with atypical findings

Dimitrios Karagiannis et al. Case Rep Med. 2014.

Abstract

Background. To report a case of acute zonal occult outer retinopathy (AZOOR) with atypical electrophysiology findings. Case Presentation. A 23-year-old-female presented with visual acuity deterioration in her right eye accompanied by photopsia bilaterally. Corrected distance visual acuity at presentation was 20/50 in the right eye and 20/20 in the left eye. Fundus examination was unremarkable. Visual field (VF) testing revealed a large scotoma. Pattern and full-field electroretinograms (PERG and ERG) revealed macular involvement associated with generalized retinal dysfunction. Electrooculogram (EOG) light rise and the Arden ratio were within normal limits bilaterally. The patient was diagnosed with AZOOR due to clinical findings, visual field defect, and ERG findings. Conclusion. This is a case of AZOOR with characteristic VF defects and clinical symptoms presenting with atypical EOG findings.

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Figures

Figure 1
Figure 1
Visual field of the patient's right eye demonstrating a generalized depression.
Figure 2
Figure 2
Optical coherence tomography of the macula without any abnormal findings.
Figure 3
Figure 3
(a) Pattern electroretinogram (PERG) showing reduction of the P50 amplitude in the right eye. (b) Bright flash dark adapted ERGs (DA 11.0) demonstrating a “negative” ERG in the right eye, as b-wave is of a lower amplitude than a-wave. (c) Photopic single flash ERGs (LA 3.0) responses were subnormal in the right eye. (d) Light adapted 30 Hz flicker ERG (LA 30 Hz) demonstrating implicit time delay in the right eye.
Figure 4
Figure 4
EOG recordings demonstrating a normal light rise and Arden ratio bilaterally.
Figure 5
Figure 5
Visual field of right eye (a) and left eye (b) demonstrating deterioration of the right eye and involvement of the left.
See this image and copyright information in PMC

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