AZOOR with unilateral disc edema: An atypical case report

Area of Science:

• Ophthalmology
• Neuro-ophthalmology
• Retinal Diseases

Background:

• Acute zonal occult outer retinopathy (AZOOR) is a rare condition characterized by progressive visual field loss.
• Early diagnosis of AZOOR is crucial for timely management, but it is often challenging due to atypical presentations.
• Optic disc edema is not a commonly reported sign in typical AZOOR cases.

Observation:

• A 19-year-old female presented with painless vision loss and optic disc edema in one eye.
• Initial symptoms suggested non-infectious optic neuritis, leading to corticosteroid treatment.
• Persistent visual field defects and characteristic retinal findings emerged upon further investigation.

Findings:

• Funduscopic examination revealed optic disc edema, an enlarged blind spot, and later, peripapillary atrophy with zonal hyperautofluorescence.
• Optical coherence tomography (OCT) showed significant loss of outer retinal layers.
• Electroretinogram (ERG) demonstrated a weakened signal in the affected retinal region.

Implications:

• Unilateral optic disc edema can be an atypical presenting sign of AZOOR, complicating early diagnosis.
• Recognizing these unusual presentations is vital for accurate and prompt diagnosis of AZOOR.
• This case underscores the importance of considering AZOOR even with non-classic symptoms to prevent diagnostic delays.