TY - JOUR
T1 - Photoreceptor attenuation in acute zonal occult outer retinopathy
AU - Kiernan, Daniel F.
AU - Ksiazek, Susan M.
AU - Jampol, Lee Merrill
AU - Grassi, Michael A.
PY - 2010/9/1
Y1 - 2010/9/1
N2 - 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.
AB - 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.
KW - Acute zonal occult outer retinopathy
KW - Autofluorescence
KW - Fluorescein angiography
KW - Indocyanine green angiography
KW - Spectral-domain optical coherence tomography
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U2 - 10.1097/ICB.0b013e3181d42801
DO - 10.1097/ICB.0b013e3181d42801
M3 - Article
C2 - 25390913
AN - SCOPUS:80052213106
VL - 4
SP - 339
EP - 345
JO - Retinal Cases and Brief Reports
JF - Retinal Cases and Brief Reports
SN - 1935-1089
IS - 4
ER -