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Improved Photoreceptor Function in Male Acute Zonal Occult Outer Retinopathy
Tsutomu Sakai1, Tamaki Gekka, Kenichi Kohzaki
1*MD, PhD Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan (all authors).
Purpose:
To describe male acute zonal occult outer retinopathy (AZOOR) patients with improvement of photoreceptor structure and visual function.
Case Series:
Medical records for eight eyes in seven patients (mean age, 36.9 years; range, 22 to 57 years) with AZOOR were reviewed retrospectively. Of the seven patients, four were treated with high-dose methylprednisolone therapy and three were not treated. All patients presented with photopsias and severe vision loss in the affected eyes. Visual acuity ranged from 0.2 to 1.5 on a Snellen decimal scale and Humphrey visual field testing showed blind spot enlargement or ring scotomas. Fundus and angiographic examinations found no specific abnormalities, leading to a diagnosis of AZOOR. Spectral domain optical coherence tomography showed attenuation of the photoreceptor inner segment ellipsoid zone. Multifocal electroretinography demonstrated that there were decreased responses at the site of the spectral domain optical coherence tomography abnormalities and corresponding visual field loss. Three patients had a spontaneous resolution with restoration of photoreceptor structure and visual function, and four patients had a visual improvement with restoration of photoreceptor structure and visual function after steroid pulse therapy.
Conclusions:
These results suggest that male AZOOR patients may have a tendency of visual improvement both with and without treatment.
