TY - JOUR
T1 - Outer retinal structure in patients with acute zonal occult outer retinopathy
AU - Mkrtchyan, Marianna
AU - Lujan, Brandon J.
AU - Merino, David
AU - Thirkill, Charles E.
AU - Roorda, Austin
AU - Duncan, Jacque L.
N1 - Funding Information:
All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Publication of this article was supported by Foundation Fighting Blindness, Columbia, Maryland; Research to Prevent Blindness, New York, New York; Hope for Vision, Washington, D.C.; That Man May See, Inc., San Francisco, California; and National Institute of Health , (Bethesda, Maryland) grants EY014375 , EY002162 , 1 P30 EY12576-6 , NIH K12 EY017269 , NIH T35 EY007139-16 .. Austin Roorda holds a patent (US Patent # 7118216) for adaptive optics scanning laser ophthalmoscopy technology. Brandon Lujan is a consultant for Carl Zeiss Meditec, AG and Genentech, Inc. Involved in design and conduct of the study (A.R., B.L., J.L.D.); collection, management, analysis, and interpretation of the data (M.M., B.J.L., D.M., C.E.T., A.R., J.L.D.); and preparation, review, and approval of the manuscript (M.M., B.L.J., C.E.T., A.R., J.L.D.). Research procedures adhered to the tenets of the Declaration of Helsinki. The study protocol was approved prospectively by the institutional review boards of the University of California, San Francisco; the University of California, Berkeley; and the University of California, Davis. All subjects gave written informed consent before participation in the studies, and the work was HIPAA-compliant. The trial was registered on www.clinicaltrials.gov as NCT00254605 . The authors thank David Birch, Retina Foundation of the Southwest, Dallas, Texas for guidance on dark- and light-adapted 2-color microperimetry protocol development. The authors also thank Carl Jacobsen, UC Berkeley School of Optometry, Berkeley, California for sharing his clinical findings on Patient 3.
PY - 2012/4
Y1 - 2012/4
N2 - Purpose: To correlate visual function with high-resolution images of retinal structure using adaptive optics scanning laser ophthalmoscopy (AOSLO) in 4 patients with acute zonal occult outer retinopathy (AZOOR). Design: Observational case series. Methods: Four women, aged 18 to 51, with acute focal loss of visual field or visual acuity, photopsia, and minimal funduscopic changes were studied with best-corrected visual acuity (BCVA), Goldmann kinetic and automated perimetry and fundus-guided microperimetry, full-field and multifocal electroretinography (ffERG and mfERG), spectral-domain optical coherence tomography (SD-OCT), and AOSLO imaging. Cone spacing was measured in 4 eyes and compared with 27 age-similar normal eyes. Additional functional testing in 1 patient suggested that cones were absent but rods remained. Serum from all patients was analyzed for anti-retinal antibody activity. Results: In all patients vision loss was initially progressive, then stable. Symptoms were unilateral in 2 and bilateral but asymmetric in 2 patients. In each patient, loss of retinal function correlated with structural changes in the outer retina. AOSLO showed focal cone loss in most patients, although in 1 patient with central vision loss such change was absent. In another patient, structural and functional analyses suggested that cones had degenerated but rods remained. Anti-retinal antibody activity against a ∼45 kd antigen was detected in 1 of the patients; the other 3 patients showed no evidence of abnormal anti-retinal antibodies. Conclusions: Focal abnormalities of retinal structure correlated with vision loss in patients with AZOOR. High-resolution imaging can localize and demonstrate the extent of outer retinal abnormality in AZOOR patients.
AB - Purpose: To correlate visual function with high-resolution images of retinal structure using adaptive optics scanning laser ophthalmoscopy (AOSLO) in 4 patients with acute zonal occult outer retinopathy (AZOOR). Design: Observational case series. Methods: Four women, aged 18 to 51, with acute focal loss of visual field or visual acuity, photopsia, and minimal funduscopic changes were studied with best-corrected visual acuity (BCVA), Goldmann kinetic and automated perimetry and fundus-guided microperimetry, full-field and multifocal electroretinography (ffERG and mfERG), spectral-domain optical coherence tomography (SD-OCT), and AOSLO imaging. Cone spacing was measured in 4 eyes and compared with 27 age-similar normal eyes. Additional functional testing in 1 patient suggested that cones were absent but rods remained. Serum from all patients was analyzed for anti-retinal antibody activity. Results: In all patients vision loss was initially progressive, then stable. Symptoms were unilateral in 2 and bilateral but asymmetric in 2 patients. In each patient, loss of retinal function correlated with structural changes in the outer retina. AOSLO showed focal cone loss in most patients, although in 1 patient with central vision loss such change was absent. In another patient, structural and functional analyses suggested that cones had degenerated but rods remained. Anti-retinal antibody activity against a ∼45 kd antigen was detected in 1 of the patients; the other 3 patients showed no evidence of abnormal anti-retinal antibodies. Conclusions: Focal abnormalities of retinal structure correlated with vision loss in patients with AZOOR. High-resolution imaging can localize and demonstrate the extent of outer retinal abnormality in AZOOR patients.
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U2 - 10.1016/j.ajo.2011.09.007
DO - 10.1016/j.ajo.2011.09.007
M3 - Article
C2 - 22105799
AN - SCOPUS:84859105188
SN - 0002-9394
VL - 153
SP - 757-768.e1
JO - American journal of ophthalmology
JF - American journal of ophthalmology
IS - 4
ER -