Photoreceptor attenuation in acute zonal occult outer retinopathy

Daniel F. Kiernan, Susan M. Ksiazek, Lee M. Jampol, Michael A. Grassi*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Purpose: The purpose of this study is to report a case of acute zonal occult outer retinopathy and to describe a novel method of imaging photoreceptor damage using Cirrus spectral-domain optical coherence tomography (SD-OCT; Cirrus, Carl Zeiss Meditec, Dublin, CA) en face visualization. Our examination also included color fundus photographs, Goldmann visual field, fluorescein and indocyanine green angiography, fundus autofluorescence, and Ganzfeld electroretinography. Methods: This is a case report of a single patient. Results: Despite 20/20 visual acuity in both of our patient's eyes, Goldmann visual field showed a unilateral C-shaped scotoma centered on the left optic nerve, sparing the fovea. Fundus and angiographic findings showed nonspecific pigmentary changes and hyperfluorescent foci along the superior and inferior vascular arcades. The electroretinography showed decreased scotopic amplitudes, with impaired 30-Hz flicker response, and Cirrus SD-OCT showed loss of the inner segment/outer segment photoreceptor junction. Cirrus SD-OCT Advanced Visualization three-dimensional reconstruction with en face visualization delineated an area of inner segment/outer segment attenuation corresponding to the Goldmann visual field scotoma. The patient's condition was unchanged at 5 months follow-up. Conclusion: In addition to classic diagnostic modalities, photoreceptor attenuation observed with Cirrus SD-OCT can contribute to the diagnosis of acute zonal occult outer retinopathy and may help elucidate the etiology of this puzzling condition.

Original languageEnglish (US)
Pages (from-to)339-345
Number of pages7
JournalRetinal Cases and Brief Reports
Issue number4
StatePublished - Sep 2010


  • Acute zonal occult outer retinopathy
  • Autofluorescence
  • Fluorescein angiography
  • Indocyanine green angiography
  • Spectral-domain optical coherence tomography

ASJC Scopus subject areas

  • Ophthalmology


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