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45-year-old man was seen in the office on 1-29-08. He had muscle surgery when he was a child for strabismus. He does not, to his knowledge, have any problem with amblyopia. He noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay. VISUAL ACUITY: OD: 20/20; OS: 20/40. IOP: OS: 16, OS: 15. Color vision: 8/10 correct in each eye. Slit Lam Exam: Normal with clear lenses. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.2. There is no posterior vitreous separation. There is a nevus inferior to the fovea. OS: Vertical C/D ratio is 0.1. There is 1+ vitreous cells. The optic nerve is pink. There are peripheral bone spicules extending from 9:00 around to 6:00 sparing the macula. Photos confirm clinical findings. A fluorescein angiogram shows typical hyperfluorescence and window defects in the areas of the bone spicules, which are only present in the left eye and spare the macula, as you would expect in a patient with retinitis pigmentosa. IMPRESSION: 1. PERIPHERAL BONE SPICULES IN THE LEFT EYE. 2. POSSIBLY UNILATERAL RETINITIS PIGMENTOSA. 3. PROBABLE ACUTE ZONAL OCCULT OUTER RETINOPATHY. DISCUSSION: I explained to the patient that the signs in the left eye are consistent with retinitis pigmentosa, however this is typically a bilateral disease. There are reported cases in the literature of unilateral retinitis pigmentosa, but most of these pre-date the description of AZOOR, which has findings similar to that seen in retinitis pigmentosa. This patient’s eye is slightly different than most AZOOR eyes I have seen in that the patches of bone spicules in the left eye are in the periphery as you would expect in patients with retinitis pigmentosa. It is interesting, though, that the inferonasal quadrant is spared in the left eye. The only infectious disease I ordered blood tests for is syphilis, to rule that out. I asked him to return here for a check in three to four months, sooner should he notice any problem, and to see you back periodically.

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Acute Zonal Occult Outer Retinopathy696 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
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(0 votes)
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Acute Zonal Occult Outer Retinopathy563 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
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(0 votes)
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Acute Zonal Occult Outer Retinopathy513 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
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(0 votes)
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Acute Zonal Occult Outer Retinopathy592 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
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(0 votes)
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Acute Zonal Occult Outer Retinopathy437 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
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(0 votes)
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Acute Zonal Occult Outer Retinopathy442 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
00000
(0 votes)
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Acute Zonal Occult Outer Retinopathy610 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
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(0 votes)
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Acute Zonal Occult Outer Retinopathy434 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
00000
(0 votes)
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Acute Zonal Occult Outer Retinopathy382 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
00000
(0 votes)
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Acute Zonal Occult Outer Retinopathy486 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
00000
(0 votes)
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Acute Zonal Occult Outer Retinopathy484 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
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(0 votes)
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Acute Zonal Occult Outer Retinopathy556 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
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(0 votes)
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Acute Zonal Occult Outer Retinopathy456 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
00000
(0 votes)
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Acute Zonal Occult Outer Retinopathy350 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
00000
(0 votes)
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Acute Zonal Occult Outer Retinopathy350 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
00000
(0 votes)
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Acute Zonal Occult Outer Retinopathy299 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
00000
(0 votes)
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Acute Zonal Occult Outer Retinopathy305 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
00000
(0 votes)
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Acute Zonal Occult Outer Retinopathy419 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
00000
(0 votes)
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Acute Zonal Occult Outer Retinopathy422 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
00000
(0 votes)
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Acute Zonal Occult Outer Retinopathy398 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
00000
(0 votes)
azoordamc_282129.png
Acute Zonal Occult Outer Retinopathy381 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
00000
(0 votes)
azoordamc_281329.png
Acute Zonal Occult Outer Retinopathy378 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
00000
(0 votes)
azoordamc_28229.png
Acute Zonal Occult Outer Retinopathy502 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.

VISUAL ACUITY: OD: 20/20; OS: 20/40.
00000
(0 votes)
 
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45-year-old man was seen in the office on 1-29-08. He had muscle surgery when he was a child for strabismus. He does not, to his knowledge, have any problem with amblyopia. He noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay. VISUAL ACUITY: OD: 20/20; OS: 20/40. IOP: OS: 16, OS: 15. Color vision: 8/10 correct in each eye. Slit Lam Exam: Normal with clear lenses. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.2. There is no posterior vitreous separation. There is a nevus inferior to the fovea. OS: Vertical C/D ratio is 0.1. There is 1+ vitreous cells. The optic nerve is pink. There are peripheral bone spicules extending from 9:00 around to 6:00 sparing the macula. Photos confirm clinical findings. A fluorescein angiogram shows typical hyperfluorescence and window defects in the areas of the bone spicules, which are only present in the left eye and spare the macula, as you would expect in a patient with retinitis pigmentosa. IMPRESSION: 1. PERIPHERAL BONE SPICULES IN THE LEFT EYE. 2. POSSIBLY UNILATERAL RETINITIS PIGMENTOSA. 3. PROBABLE ACUTE ZONAL OCCULT OUTER RETINOPATHY. DISCUSSION: I explained to the patient that the signs in the left eye are consistent with retinitis pigmentosa, however this is typically a bilateral disease. There are reported cases in the literature of unilateral retinitis pigmentosa, but most of these pre-date the description of AZOOR, which has findings similar to that seen in retinitis pigmentosa. This patient’s eye is slightly different than most AZOOR eyes I have seen in that the patches of bone spicules in the left eye are in the periphery as you would expect in patients with retinitis pigmentosa. It is interesting, though, that the inferonasal quadrant is spared in the left eye. The only infectious disease I ordered blood tests for is syphilis, to rule that out. I asked him to return here for a check in three to four months, sooner should he notice any problem, and to see you back periodically.