Acute zonal occult outer retinopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

Lin Yijun ,  Dou Hongliang

Peking University Third Hospital, Peking University Eye Center, Beijing 100191, China;

Corresponding author：

Dou Hongliang, Email: douhl@aliyun.com

Keywords：

Retinal diseases; Disease attributes; Visual field tests; Tomography, optical coherence; Electroretinography; Review

DOI：

10.3760/cma.j.issn.1005-1015.2019.03.022

Video：

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Acute zonal occult outer retinopathy (AZOOR) is an acquired retinal diseases. The majority of patients who develop AZOOR are women characterized by an acute onset of visual blurred and scotoma with photopsias. The fundus examination is often normal or appeared mild abnormal. The RPE atrophy of fundus is similar with white syndrome. Although FFA and ICGA features are either unremarkable or unrelated to AZOOR, there are still important in differential diagnosis. The characteristic abnormalities appearance of FAF (complicated and varied), OCT (regional anomaly of ellipsoid zone), visual field (visual field defect) and ERG (decreased amplitude and prolonged latency of rod reaction, maximum reaction, cone reaction and scintillation reaction) are considered critical examinations to the diagnosis of AZOOR. Although there is no effective therapy for AZOOR, it has some self-limitation.

Citation： Lin Yijun, Dou Hongliang. Acute zonal occult outer retinopathy. Chinese Journal of Ocular Fundus Diseases, 2019, 35(3): 302-305. doi: 10.3760/cma.j.issn.1005-1015.2019.03.022 Copy

1.	Gass JD. Acute zonal occult outer retinopathy. Donders Lecture: The Netherlands Ophthalmological Society, Maastricht, Holland, June 19, 1992[J]. J Clin Neuro-ophthalmol, 1993, 13(2): 79-97.
2.	Gass JD, Agarwal A, Scott IU. Acute zonal occult outer retinopathy: a long-term follow-up study[J]. Am J Ophthalmol, 2002, 134(3): 329-339. DOI: 10.1016/S0002-9394(02)01640-9.
3.	Jacobson SG, Morales DS, Sun XK, et al. Pattern of retinal dysfunction in acute zonal occult outer retinopathy[J]. Ophthalmology, 1995, 102(8): 1187-1198. DOI: 10.1016/S0161-6420(95)30891-3.
4.	Fujiwara T, Imamura Y, Giovinazzo VJ, et al. Fundus autofluorescence and optical coherence tomographic findings in acute zonal occult outer retinopathy[J]. Retina, 2010, 30(8): 1206-1216. DOI: 10.1097/IAE.0b013e3181e097f0.
5.	Kuniyoshi K, Sakuramoto H, Nakao Y, et al. Two types of acute zonal occult outer retinopathy differentiated by dark- and light-adapted perimetry[J]. Jpn J Ophthalmol, 2014, 58(2): 177-187. DOI: 10.1007/s10384-013-0297-x.
6.	Sakai T, Gekka T, Kohzaki K, et al. Improved photoreceptor function in male acute zonal occult outer retinopathy[J]. Optom Vis Sci, 2015, 92(10): 371-379. DOI: 10.1097/OPX.0000000000000683.
7.	Mrejen S, Khan S, Gallego-Pinazo R, et al. Acute zonal occult outer retinopathy: a classification based on multimodal imaging[J]. JAMA Ophthalmol, 2014, 132(9): 1089-1098. DOI: 10.1001/jamaophthalmol.2014.1683.
8.	Song ZM, Sheng YJ, Chen QS, et al. Clinical characteristics of acute zonal occult outer retinopathy in Chinese patients[J]. Ophthalmologica, 2008, 222(3): 149-156. DOI: 10.1159/000126076.
9.	Saito S, Saito W, Saito M, et al. Acute zonal occult outer retinopathy in Japanese patients: clinical features, visual function, and factors affecting visual function[J/OL]. PLoS One, 2015, 10(4): 0125133[2015-04-28]. http://dx.plos.org/10.1371/journal.pone.0125133. DOI: 10.1371/journal.pone.0125133.
10.	Shifera AS, Pennesi ME, Yang P, et al. Ultra-wide-field fundus autofluorescence findings in patients with acute zonal occult outer retinopathy[J]. Retina, 2017, 37(6): 1104-1119. DOI: 10.1097/IAE.0000000000001311.
11.	So K, Shinoda K, Matsumoto CS, et al. Focal functional and microstructural changes of photoreceptors in eyes with acute zonal occult outer retinopathy[J]. Case Rep Ophthalmol, 2011, 2(3): 307-313. DOI: 10.1159/000332734.
12.	Ohta K, Sato A, Fukui E. Spectral domain optical coherence tomographic findings at convalescent stage of acute zonal occult outer retinopathy[J]. Clin Ophthalmol, 2009, 3: 423-428.
13.	Nakao S, Kaizu Y, Yoshida S, et al. Spontaneous remission of acute zonal occult outer retinopathy: follow-up using adaptive optics scanning laser ophthalmoscopy[J]. Graefe's Arch Clin Exp Ophthalmol, 2015, 253(6): 839-843. DOI: 10.1007/s00417-014-2760-x.
14.	Naik AU, Ezhilvathani N, Biswas J. Acute zonal occult outer retinopathy: is optical coherence tomography angiography useful?[J]. Indian J Ophthalmol, 2018, 66(11): 1637-1639. DOI: 10.4103/ijo.IJO_966_18.
15.	Monson DM, Smith JR. Acute zonal occult outer retinopathy[J]. Surv Ophthalmol, 2011, 56(1): 23-35. DOI: 10.1016/j.survophthal.2010.07.004.
16.	Francis PJ, Marinescu A, Fitzke FW, et al. Acute zonal occult outer retinopathy: towards a set of diagnostic criteria[J]. Br J Ophthalmol, 2005, 89(1): 70-73. DOI: 10.1136/bjo.2004.042416.
17.	Kure K, Obata R, Inoue Y, et al. Acute progression of electrophysiologically affected fellow eye in unilaterally symptomatic acute zonal occult outer retinopathy[J]. Clin Ophthalmol, 2011, 5: 1167-1170. DOI: 10.2147/OPTH.S23207.
18.	Mkrtchyan M, Lujan BJ, Merino D, et al. Outer retinal structure in patients with acute zonal occult outer retinopathy[J]. Am J Ophthalmol, 2012, 153(4): 757-768. DOI: 10.1016/j.ajo.2011.09.007.
19.	Gass JD. Are acute zonal occult outer retinopathy and the white spot syndromes (AZOOR complex) specific autoimmune diseases?[J]. Am J Ophthalmol, 2003, 135(3): 380-381. DOI: 10.1016/S0002-9394(03)00030-8.
20.	Jampol LM, Becker KG. White spot syndromes of the retina: a hypothesis based on the common genetic hypothesis of autoimmune/inflammatory disease[J]. Am J Ophthalmol, 2003, 135(3): 376-379. DOI: 10.1016/S0002-9394(02)02088-3.
21.	Mahajan VB, Stone EM. Patients with an acute zonal occult outer retinopathy-like illness rapidly improve with valacyclovir treatment[J]. Am J Ophthalmol, 2010, 150(4): 511-518. DOI: 10.1016/j.ajo.2010.05.024.
22.	Hoang QV, Gallego-Pinazo R, Yannuzzi LA. Long-term follow-up of acute zonal occult outer retinopathy[J]. Retina, 2013, 33(7): 1325-1327. DOI: 10.1097/IAE.0b013e318286cc57.

1. Gass JD. Acute zonal occult outer retinopathy. Donders Lecture: The Netherlands Ophthalmological Society, Maastricht, Holland, June 19, 1992[J]. J Clin Neuro-ophthalmol, 1993, 13(2): 79-97.
2. Gass JD, Agarwal A, Scott IU. Acute zonal occult outer retinopathy: a long-term follow-up study[J]. Am J Ophthalmol, 2002, 134(3): 329-339. DOI: 10.1016/S0002-9394(02)01640-9.
3. Jacobson SG, Morales DS, Sun XK, et al. Pattern of retinal dysfunction in acute zonal occult outer retinopathy[J]. Ophthalmology, 1995, 102(8): 1187-1198. DOI: 10.1016/S0161-6420(95)30891-3.
4. Fujiwara T, Imamura Y, Giovinazzo VJ, et al. Fundus autofluorescence and optical coherence tomographic findings in acute zonal occult outer retinopathy[J]. Retina, 2010, 30(8): 1206-1216. DOI: 10.1097/IAE.0b013e3181e097f0.
5. Kuniyoshi K, Sakuramoto H, Nakao Y, et al. Two types of acute zonal occult outer retinopathy differentiated by dark- and light-adapted perimetry[J]. Jpn J Ophthalmol, 2014, 58(2): 177-187. DOI: 10.1007/s10384-013-0297-x.
6. Sakai T, Gekka T, Kohzaki K, et al. Improved photoreceptor function in male acute zonal occult outer retinopathy[J]. Optom Vis Sci, 2015, 92(10): 371-379. DOI: 10.1097/OPX.0000000000000683.
7. Mrejen S, Khan S, Gallego-Pinazo R, et al. Acute zonal occult outer retinopathy: a classification based on multimodal imaging[J]. JAMA Ophthalmol, 2014, 132(9): 1089-1098. DOI: 10.1001/jamaophthalmol.2014.1683.
8. Song ZM, Sheng YJ, Chen QS, et al. Clinical characteristics of acute zonal occult outer retinopathy in Chinese patients[J]. Ophthalmologica, 2008, 222(3): 149-156. DOI: 10.1159/000126076.
9. Saito S, Saito W, Saito M, et al. Acute zonal occult outer retinopathy in Japanese patients: clinical features, visual function, and factors affecting visual function[J/OL]. PLoS One, 2015, 10(4): 0125133[2015-04-28]. http://dx.plos.org/10.1371/journal.pone.0125133. DOI: 10.1371/journal.pone.0125133.
10. Shifera AS, Pennesi ME, Yang P, et al. Ultra-wide-field fundus autofluorescence findings in patients with acute zonal occult outer retinopathy[J]. Retina, 2017, 37(6): 1104-1119. DOI: 10.1097/IAE.0000000000001311.
11. So K, Shinoda K, Matsumoto CS, et al. Focal functional and microstructural changes of photoreceptors in eyes with acute zonal occult outer retinopathy[J]. Case Rep Ophthalmol, 2011, 2(3): 307-313. DOI: 10.1159/000332734.
12. Ohta K, Sato A, Fukui E. Spectral domain optical coherence tomographic findings at convalescent stage of acute zonal occult outer retinopathy[J]. Clin Ophthalmol, 2009, 3: 423-428.
13. Nakao S, Kaizu Y, Yoshida S, et al. Spontaneous remission of acute zonal occult outer retinopathy: follow-up using adaptive optics scanning laser ophthalmoscopy[J]. Graefe's Arch Clin Exp Ophthalmol, 2015, 253(6): 839-843. DOI: 10.1007/s00417-014-2760-x.
14. Naik AU, Ezhilvathani N, Biswas J. Acute zonal occult outer retinopathy: is optical coherence tomography angiography useful?[J]. Indian J Ophthalmol, 2018, 66(11): 1637-1639. DOI: 10.4103/ijo.IJO_966_18.
15. Monson DM, Smith JR. Acute zonal occult outer retinopathy[J]. Surv Ophthalmol, 2011, 56(1): 23-35. DOI: 10.1016/j.survophthal.2010.07.004.
16. Francis PJ, Marinescu A, Fitzke FW, et al. Acute zonal occult outer retinopathy: towards a set of diagnostic criteria[J]. Br J Ophthalmol, 2005, 89(1): 70-73. DOI: 10.1136/bjo.2004.042416.
17. Kure K, Obata R, Inoue Y, et al. Acute progression of electrophysiologically affected fellow eye in unilaterally symptomatic acute zonal occult outer retinopathy[J]. Clin Ophthalmol, 2011, 5: 1167-1170. DOI: 10.2147/OPTH.S23207.
18. Mkrtchyan M, Lujan BJ, Merino D, et al. Outer retinal structure in patients with acute zonal occult outer retinopathy[J]. Am J Ophthalmol, 2012, 153(4): 757-768. DOI: 10.1016/j.ajo.2011.09.007.
19. Gass JD. Are acute zonal occult outer retinopathy and the white spot syndromes (AZOOR complex) specific autoimmune diseases?[J]. Am J Ophthalmol, 2003, 135(3): 380-381. DOI: 10.1016/S0002-9394(03)00030-8.
20. Jampol LM, Becker KG. White spot syndromes of the retina: a hypothesis based on the common genetic hypothesis of autoimmune/inflammatory disease[J]. Am J Ophthalmol, 2003, 135(3): 376-379. DOI: 10.1016/S0002-9394(02)02088-3.
21. Mahajan VB, Stone EM. Patients with an acute zonal occult outer retinopathy-like illness rapidly improve with valacyclovir treatment[J]. Am J Ophthalmol, 2010, 150(4): 511-518. DOI: 10.1016/j.ajo.2010.05.024.
22. Hoang QV, Gallego-Pinazo R, Yannuzzi LA. Long-term follow-up of acute zonal occult outer retinopathy[J]. Retina, 2013, 33(7): 1325-1327. DOI: 10.1097/IAE.0b013e318286cc57.

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