Acute Zonal Occult Outer Retinopathy - AZOOR
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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 Retinopathyvista 1285 veces45-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. 
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 1136 veces45-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.
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 969 veces45-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.
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 1036 veces45-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.
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 836 veces45-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.
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 860 veces45-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.
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 1090 veces45-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.
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 892 veces45-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.
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 814 veces45-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.
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 969 veces45-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.
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 1033 veces45-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.
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 1148 veces45-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.
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 869 veces45-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.
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 748 veces45-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.
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 753 veces45-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.
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 668 veces45-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.
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 706 veces45-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.
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 821 veces45-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.
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 827 veces45-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.
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 866 veces45-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.
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 768 veces45-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.
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 797 veces45-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.
(0 votos)
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Acute Zonal Occult Outer Retinopathyvista 951 veces45-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.
(0 votos)
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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.
