Progressive Enlarging Blind Spot in a Young Asian Lady: A Case Report on Acute Zonal Occult Outer Retinopathy
AbstractAcute Zonal Occult Outer Retinopathy (AZOOR) is a very rare retinal disease that predominantly affect the Caucasians. It is usually present in a young myopic woman with an acute onset of photopsia and enlarging blind spots. Here, we report a young Asian lady who presented with a typical presentation of AZOOR and later confirmed by electrophysiological test of the retina. She was wrongly diagnosed as retrobulbar optic neuritis due to low index of suspicion for AZOOR among the treating physicians in the hospital. Fortunately, she responded to systemic corticosteroid that was given as a treatment of optic neuritis. AZOOR was only diagnosed later by a visiting European neuro-ophthalmologist in a neighbouring country. The objective of this case report is to remind the reader that the condition exists in Asian population and should be kept as a differential diagnosis in a young lady who presented with progressive visual field defect.
Gass JD. Acute zonal occult outer retinopathy. Donders Lecture: The Netherlands Ophthalmological Society, Maastricht, Holland, June 19, 1992. J Clin Neuroophthalmol. 1993; 13: 79–97. pmid:8340485.
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 Experiment Ophthalmol. 2014; 42: 139–150. pmid:23777505.
Gass JD, Agarwal A, Scott IU. Acute zonal occult outer retinopathy: a long-term follow-up study. Am J Ophthalmol. 2002;134:329–39.
Monson DM, Smith JR. Acute zonal occult outer retinopathy. Surv Ophthalmol. 2011; 56: 23–35. doi:10.1016/j.survophthal. 2010.07.004 pmid: 21056448.
Bae KW, Park KH, Woo SJ, Hwang JM. Clinical Characteristics of Acute Zonal Occult Outer Retinopathy. J Korean Ophthalmol Soc. 2016 Mar;57:413-419.
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 Apr 28;10:e0125133.
Song ZM, Sheng YJ, Chen QS, et al. Clinical characteristics of acute zonal occult outer retinopathy in Chinese patients. Ophthalmologica. 2008;222:149-56.
Chen SN, Hwang JF. Ocular coherence tomographic and clinical characteristics in patients of punctuate inner choroidopathy associated with zonal outer retinopathy. Ocular immunology and inflammation. 2014 Aug 1;22:263-9.
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;124:249-254.
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