Detaillierte Beitrags-Information

Zurück zur Liste

Beitragstitel Structural and functional outcome in patients with Acute Zonal Occult Outer Retinopathy
Autor:innen
  1. Scott Tschuppert Kantonsspital St. Gallen Präsentierende:r
  2. Christophe Valmaggia Kantonsspital St. Gallen
  3. Reinhard Rüesch KSSG Kantonsspital St. Gallen
  4. Margarita G. Todorova Kantonsspital St. Gallen
Präsentationsform Free Paper
Themengebiete
  • Uveitis / Intraocular Inflammation
Abstract-Text Background: Acute zonal occult outer retinopathy (AZOOR) is a rare retinal disorder of unknown cause and little knowledge to its clinical course and treatment. The aim of this study was to evaluate retrospectively the structural and functional outcome in patients with AZOOR.
Patients and Methods: Six patients (4 women and 2 men; mean age 34y), treated for AZOOR at our hospital, were analysed. Clinical examination was supported by spectral domain optical coherence tomography (SD-OCT), fundus autofluorescence (FAF), near-infrared reflectance (NIR-R), multifocal electroretinogram (mf-ERG), full-field electroretinogram (ffERG), fluorescein angiography (FA), perimetry, blood testing and MRI of the neurocranium.
Results: In all six patients, only one eye was affected on presentation. One patient developed AZOOR in the fellow eye and one patient had a recurrence in the same eye in follow-up. Each patient presented either with scotoma, photopsia, or blurry vision. Initial BCVA varied from 20/20 to 20/200, whereas final BCVA ranged from 20/16 to 20/800 . SD-OCT revealed irregularities of the ellipsoid zone in all affected eyes. Mf-ERG showed reduced focal responses (in 5 of 6 affected eyes) and ff-ERG: reduced amplitudes, predominantly affecting photopic responses (in 4 of 5 examined affected eyes). Autoimmune disease (Psoriasis) was confirmed in one patient. Blood testing was performed in 5 out of 6 patients, in one patient exceptionally high borrelia IgG titers (IgM neg.) were found. Three patients (including mentioned patient) were positive for varicella zoster IgG (IgM neg.), two of which were also positive for herpes simplex virus IgG (IgM neg.). Two patients had unobtrusive blood tests. MRI of the neurocranium showed in one case a minimal uptake of contrast in the optic nerve sheath. The case with the high borrelia titer, showed a thrombosis of the sinus transversus during therapy. The three other MRIs were normal.
Conclusion: Even if the value of treatment in AZOOR stays uncertain, early multimodal imaging may help to reduce delay in diagnosis and is a helpful in monitoring the course of the disease.