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Spontaneous remission of acute zonal occult outer retinopathy: follow-up using adaptive optics scanning laser ophthalmoscopy

  • Retinal Disorders
  • Published:
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Abstract

Purpose

The purpose of this study was to report a case of acute zonal occult outer retinopathy (AZOOR) with spontaneous remission that was followed up using adaptive optics scanning laser ophthalmoscopy (AO-SLO).

Methods

The right eye of a 31-year old myopic man diagnosed with AZOOR was followed up. The patient underwent a full ophthalmologic examination, spectral-domain optical coherence tomography (SD-OCT), multifocal electroretinography (mfERG) and imaging with prototype AO-SLO systems (Canon Inc) at the first visit, 1 month after, and 2 months after. Images focused on the photoreceptor layer were recorded in the area, and a montage of AO-SLO images was created.

Results

The patient presented with acute onset of a blind spot and photopsia in his right eye. On AO-SLO, focal dark areas could be observed on the right eye but not on the left eye at the first examination (cone density 8,589/mm2, mosaic regularity of cone photoreceptors 38.5 %, cone spacing 0.567). The dark areas on AO-SLO corresponded to areas of disrupted inner segments and outer segments (IS/OS) line or ellipsoid of the IS and abnormal area in mfERG. After 1 and 2 months, his symptoms tended to disappear gradually without any treatment. IS/OS line and mfERG could be nearly normalized. Furthermore, normal cone mosaic could be observed in areas where some focal dark spots could be observed at the first examination (cone density 10,112/mm2, mosaic regularity of cone photoreceptors 39.9 %, cone spacing 0.606).

Conclusion

AO-SLO is a useful tool of diagnosis and follow-up of AZOOR. This study might suggest reversible cone damage could occur in some cases of AZOOR with spontaneous remission.

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References

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

    CAS  PubMed  Google Scholar 

  2. Gass JD, Agarwal A, Scott IU (2002) Acute zonal occult outer retinopathy: a long-term follow-up study. Am J Ophthalmol 134:329–339

    Article  PubMed  Google Scholar 

  3. Li D, Kishi S (2007) Loss of photoreceptor outer segment in acute zonal occult outer retinopathy. Arch Ophthalmol 125:1194–1200

    Article  PubMed  Google Scholar 

  4. Spaide RF, Koizumi H, Freund KB (2008) Photoreceptor outer segment abnormalities as a cause of blind spot enlargement in acute zonal occult outer retinopathy-complex diseases. Am J Ophthalmol 146:111–120

    Article  PubMed  Google Scholar 

  5. Mkrtchyan M, Lujan BJ, Merino D, Thirkill CE, Roorda A et al (2012) Outer retinal structure in patients with acute zonal occult outer retinopathy. Am J Ophthalmol 153:757–768, 768 e751

    Article  PubMed Central  PubMed  Google Scholar 

  6. Hirose F, Nozato K, Saito K, Numajiri Y (2011) A compact adaptive optics scanning laser ophthalmoscope with high-efficiency wavefront correction using dual liquid crystal on silicon spatial light modulator. Proc SPIE 7885:788515

    Google Scholar 

  7. Makiyama Y, Ooto S, Hangai M, Takayama K, Uji A et al (2013) Macular cone abnormalities in retinitis pigmentosa with preserved central vision using adaptive optics scanning laser ophthalmoscopy. PLoS One 8:e79447

    Article  PubMed Central  PubMed  Google Scholar 

  8. Baraas RC, Carroll J, Gunther KL, Chung M, Williams DR et al (2007) Adaptive optics retinal imaging reveals S-cone dystrophy in tritan color-vision deficiency. J Opt Soc Am A Opt Image Sci Vis 24:1438–1447

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  9. Spaide RF, Curcio CA (2011) Anatomical correlates to the bands seen in the outer retina by optical coherence tomography: literature review and model. Retina 31:1609–1619

    Article  PubMed Central  PubMed  Google Scholar 

  10. Hoang QV, Linsenmeier RA, Chung CK, Curcio CA (2002) Photoreceptor inner segments in monkey and human retina: mitochondrial density, optics, and regional variation. Vis Neurosci 19:395–407

    Article  CAS  PubMed  Google Scholar 

  11. Rajendram R, Saraswathy S, Rao NA (2007) Photoreceptor mitochondrial oxidative stress in early experimental autoimmune uveoretinitis. Br J Ophthalmol 91:531–537

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

We thank Mr. Kazushi Nomura (Canon Inc.) for the technical support. Supported by grants from JSPS KAKENHI, Grant-in-Aid for Young Scientists (A) No. 25713057 (SN).

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Correspondence to Shintaro Nakao.

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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 253, 839–843 (2015). https://doi.org/10.1007/s00417-014-2760-x

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  • DOI: https://doi.org/10.1007/s00417-014-2760-x

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