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Inflammatory and Infectious Ocular Disorders pp 45–50Cite as

Acute Zonal Occult Outer Retinopathy

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Part of the book series: Retina Atlas ((RA))

Abstract

Acute zonal occult outer retinopathy (AZOOR) is an idiopathic clinical entity with acute zonal impairment of the outer retina, which initially shows no funduscopic abnormalities. AZOOR was first described by Gass in 1993 (Gass 1993) and is characterized by an acute onset of scotomata, often with photopsia in one or both eyes, minimal funduscopic changes (Fig. 6.1), and functional and morphological impairments of the outer retina detected by electroretinography (ERG) and spectral-domain optical coherence tomography (SD-OCT) (Gass et al. 2002). The retinal sites affected by AZOOR often develop zonal atrophy of the retinal pigment epithelium (RPE), which is a characteristic feature in the convalescent stage of AZOOR (Fig. 6.2).

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References

  • Arai M, Naoi N, Sawada A, et al. Multifocal electroretinogram indicates visual field loss in acute zonal occult outer retinopathy. Am J Ophthalmol. 1998;126:466–9.

    Article  CAS  Google Scholar 

  • Chai Y, Yamazaki H, Fujinami K, et al. Case of acute zonal occult outer retinopathy with abnormal pattern visual evoked potentials. Clin Ophthalmol. 2011;5:1235–41.

    Article  Google Scholar 

  • Chen SN, Yang CH, Yang CM. Systemic corticosteroids therapy in the management of acute zonal occult outer retinopathy. J Ophthalmol. 2015;2015:793026.

    PubMed  PubMed Central  Google Scholar 

  • Fagan XJ. A new insight into an old mystery. Clin Exp Ophthalmol. 2014;42:103–4.

    Article  Google Scholar 

  • Forooghian F. Prevalence of antiretinal antibodies in acute zonal occult outer retinopathy: a comprehensive review of 25 cases. Am J Ophthalmol. 2017;179:210–1.

    Article  Google Scholar 

  • Francis PJ, Marinescu A, Fitzke FW, et al. Acute zonal occult outer retinopathy: towards a set of diagnostic criteria. Br J Ophthalmol. 2005;89:70–3.

    Article  CAS  Google Scholar 

  • Fujiwara T, Imamura Y, Giovinazzo VJ, et al. Fundus autofluorescence and optical coherence tomographic findings in acute zonal occult outer retinopathy. Retina. 2010;30:1206–16.

    Article  Google Scholar 

  • Gass JDM. Acute zonal occult outer retinopathy. Donders Lecture: The Netherlands Ophthalmological Society, Maastricht, Holland, June 19, 1992. J Clin Neuroophthalmol. 1993;13:79–97.

    CAS  PubMed  Google Scholar 

  • Gass JDM. Are acute zonal occult outer retinopathy and the white spot syndromes (AZOOR complex) specific autoimmune diseases? Am J Ophthalmol. 2003;135:380–1.

    Article  Google Scholar 

  • Gass JDM, Stern C. Acute annular outer retinopathy as a variant of acute zonal occult outer retinopathy. Am J Ophthalmol. 1995;119:330–4.

    Article  CAS  Google Scholar 

  • Gass JDM, Agarwal A, Scott IU. Acute zonal occult outer retinopathy: a long-term follow-up study. Am J Ophthalmol. 2002;134:329–39.

    Article  Google Scholar 

  • Hashimoto Y, Saito W, Saito M, et al. Decreased choroidal blood flow velocity in the pathogenesis of multiple evanescent white dot syndrome. Graefes Arch Clin Exp Ophthalmol. 2015;253:1457–64.

    Article  Google Scholar 

  • Hashimoto Y, Saito W, Saito M, et al. Relationship between choroidal thickness and visual impairment in multiple evanescent white dot syndrome. Acta Ophthalmol. 2016;94:e804–6.

    Article  Google Scholar 

  • Hashimoto Y, Saito W, Saito M, et al. Relationship between choroidal thickness and visual field impairment in acute zonal occult outer retinopathy. J Ophthalmol. 2017;2017:2371032.

    PubMed  PubMed Central  Google Scholar 

  • Hashimoto Y, Saito W, Saito M, et al. Increased thickness and decreased blood flow velocity of the choroid in a patient with acute macular neuroretinopathy. BMC Ophthalmol. 2019;19:109.

    Article  Google Scholar 

  • Hintzen RQ, van den Born LI. Acute zonal occult outer retinopathy and multiple sclerosis. J Neurol Neurosurg Psychiatry. 2006;77:1373–5.

    Article  CAS  Google Scholar 

  • Hirooka K, Saito W, Hashimoto Y, et al. Increased macular choroidal blood flow velocity and decreased choroidal thickness with regression of punctate inner choroidopathy. BMC Ophthalmol. 2014a;14:73.

    Article  Google Scholar 

  • Hirooka K, Saito W, Noda K, et al. Enhanced-depth imaging optical coherence tomography and laser speckle flowgraphy in a patient with acute macular neuroretinopathy. Ocul Immunol Inflamm. 2014b;22:485–9.

    Article  Google Scholar 

  • Hirooka K, Saito W, Namba K, et al. Relationship between choroidal blood flow velocity and choroidal thickness during systemic corticosteroid therapy for Vogt-Koyanagi-Harada disease. Graefes Arch Clin Exp Ophthalmol. 2015;253:609–17.

    Article  CAS  Google Scholar 

  • Holz FG, Kim RY, Schwartz SD, et al. Acute zonal occult outer retinopathy (AZOOR) associated with multifocal choroidopathy. Eye. 1994;8:77–83.

    Article  Google Scholar 

  • Jacobson SG, Morales DS, Sun XK, et al. Pattern of retinal dysfunction in acute zonal occult outer retinopathy. Ophthalmology. 1995;102:1187–98.

    Article  CAS  Google Scholar 

  • Kitakawa T, Hayashi T, Takashina H, et al. Improvement of central visual function following steroid pulse therapy in acute zonal occult outer retinopathy. Doc Ophthalmol. 2012;124:249–54.

    Article  Google Scholar 

  • Kuniyoshi K, Sakuramoto H, Nakao Y, et al. Two types of acute zonal occult outer retinopathy differentiated by dark- and light-adapted perimetry. Jpn J Ophthalmol. 2014;58:177–87.

    Article  CAS  Google Scholar 

  • Li D, Kishi S. Loss of photoreceptor outer segment in acute zonal occult outer retinopathy. Arch Ophthalmol. 2007;125:1194–200.

    Article  Google Scholar 

  • Matsui Y, Matsubara H, Ueno S, et al. Changes in outer retinal microstructures during six month period in eyes with acute zonal occult outer retinopathy-complex. PLoS One. 2014;9:e110592.

    Article  Google Scholar 

  • Monson DM, Smith JR. Acute zonal occult outer retinopathy. Surv Ophthalmol. 2011;56:23–35.

    Article  Google Scholar 

  • Mrejen S, Khan S, Gallego-Pinazo R, et al. Acute zonal occult outer retinopathy: a classification based on multimodal imaging. JAMA Ophthalmol. 2014;132:1089–98.

    Article  Google Scholar 

  • Nakao S, Kaizu Y, Yoshida S, et al. Spontaneous remission of acute zonal occult outer retinopathy: follow-up using adaptive optics scanning laser ophthalmoscopy. Graefes Arch Clin Exp Ophthalmol. 2015;253:839–43.

    Article  Google Scholar 

  • Neri P, Ricci F, Giovannini A, et al. Successful treatment of an overlapping choriocapillaritis between multifocal choroiditis and acute zonal occult outer retinopathy (AZOOR) with adalimumab (Humira). Int Ophthalmol. 2014;34:359–64.

    Article  Google Scholar 

  • Qian CX, Wang A, DeMill DL, et al. Prevalence of anti-retinal antibodies in acute zonal occult outer retinopathy (AZOOR): a comprehensive review of 25 cases. Am J Ophthalmol. 2017;176:210–8.

    Article  Google Scholar 

  • Saito A, Saito W, Furudate N, et al. Indocyanine green angiography in a case of punctate inner choroidopathy associated with acute zonal occult outer retinopathy. Jpn J Ophthalmol. 2007;51:295–300.

    Article  Google Scholar 

  • Saito M, Saito W, Hashimoto Y, et al. Correlation between decreased choroidal blood flow velocity and the pathogenesis of acute zonal occult outer retinopathy. Clin Exp Ophthalmol. 2014;42:139–50.

    Article  Google Scholar 

  • 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. PLoS One. 2015;10:e0125133.

    Article  Google Scholar 

  • So K, Shinoda K, Matsumoto CS, et al. Focal functional and microstructural changes of photoreceptors in eyes with acute zonal occult outer retinopathy. Case Rep Ophthalmol. 2011;2:307–13.

    Article  Google Scholar 

  • Spaide RF, Koizumi H, Freund KB. Photoreceptor outer segment abnormalities as a cause of blind spot enlargement in acute zonal occult outer retinopathy-complex diseases. Am J Ophthalmol. 2008;146:111–20.

    Article  Google Scholar 

  • Tagami M, Matsumiya W, Imai H, et al. Autologous antibodies to outer retina in acute zonal occult outer retinopathy. Jpn J Ophthalmol. 2014;58:462–72.

    Article  CAS  Google Scholar 

  • Takahashi A, Saito W, Hashimoto Y, et al. Impaired circulation in the thickened choroid of a patient with serpiginous choroiditis. Ocul Immunol Inflamm. 2014;22:409–13.

    Article  Google Scholar 

  • Tsunoda K, Fujinami K, Miyake Y. Selective abnormality of cone outer segment tip line in acute zonal occult outer retinopathy as observed by spectral-domain optical coherence tomography. Arch Ophthalmol. 2011;129:1099–101.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan

    Wataru Saito & Susumu Ishida

  2. Kaimeido Eye and Dental Clinic, Sapporo, Japan

    Wataru Saito

Authors
  1. Wataru Saito
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  2. Susumu Ishida
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Correspondence to Wataru Saito .

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Editors and Affiliations

  1. Department of Ophthalmology, College of Medicine, Seoul National University, Seoul, Korea (Republic of)

    Hyeong Gon Yu

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Saito, W., Ishida, S. (2020). Acute Zonal Occult Outer Retinopathy. In: Yu, H. (eds) Inflammatory and Infectious Ocular Disorders. Retina Atlas. Springer, Singapore. https://doi.org/10.1007/978-981-13-8546-9_6

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  • DOI: https://doi.org/10.1007/978-981-13-8546-9_6

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-13-8545-2

  • Online ISBN: 978-981-13-8546-9

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