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Top rated - Acute Annular Outer Retinopathy

Initial visit (June 11, 2011): 2 days of vision loss right eye. Wedge suddenly of VA loss OD, too dardkto see through. No flashes or floaters. VA 20/20 OU. SEE INITIAL PHOTOS AND FA FU: 25-year-old woman was seen in the office on September 8, 2011. She about three months ago put on her sunglasses and noticed a smudge in the vision and at that point she noticed the right eye was hazy. She sent out an MRI scan. She had testing done. It was thought at one point she might have MEWDS. She has not had any eye pain. She did have a little cold a week or two before the vision loss, but she didn’t have any fever. She has no focal neurological problems in her past history. She has had no rashes, no shortness of breath, no ulcers, and no health problems. She doesn’t feel sick. She hasn’t had a weight loss. She hasn’t had a weight gain. She does take birth control for the last three years. VISUAL ACUITY: OD 203/0, OS 20/20. IOP: 12 OU. Color vision is normal. SLIT EXAMINATION: Normal with clear lenses. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.0. There is no vitreous cells. The macula looks normal. There is pigment atrophy in the periphery. OS: Vertical C/D ratio is 0.0. There is no vitreous cells. The macula and periphery look healthy. The retinal vessels look normal. Photos confirm clinical findings. FUNDUS AUTO FLUORESCENCE: Shows some decreased fundus auto fluorescence in the periphery. The macula of the right eye there is minimal. The left eye fundus auto fluorescence was normal. SPECTRALIS-SD-OCT SCAN: The OCT scan of the right eye was normal in the very center of the fovea, but there was loss of the photoreceptors in the periphery of the macula and then we did some spot scans in the far periphery and there was some spots in the periphery, which do show up as areas of loss of the deep retinal layers. The left eye OCT scan was completely normal in the macula and the periphery. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows irregular hyperfluorescence, which is only slight in the periphery of the right eye where there is pigment atrophy. There is no evidence of any leakage and there is no evidence of any retinal vasculitis. There is no staining of the retinal vessels nor is there staining of the optic nerve. The left eye fluorescein angiogram was completely normal. The indocyanine green angiogram shows no dark spots in either eye. It does show irregular hyperfluorescence corresponding to the pigment atrophy, which was present on the fluorescein angiogram. IMPRESSION: 1. PROBABLE ACUTE ZONAL OUTER RETINOPATHY (AZOOR IN THE RIGHT EYE) DISCUSSION: I explained to the patient the signs and symptoms were all consistent with AZOOR, which may have some recovery over time and generally is not at least progressive. There are a few blood tests which need to be checked to rule out any sort of systemic inflammatory syndrome or infection that might be an issue. I generally check for syphilis and sarcoid.

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Acute Annular Outer Retinopathy - VA loss 2 days Right Eye Only - 25 Year Old Woman- AZOOR - White Line Around Fresh Lesions324 viewsInitial visit (June 11, 2011): 2 days of vision loss right eye. Wedge suddenly of VA loss OD, too dardkto see through. No flashes or floaters. VA 20/20 OU.

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Initial visit (June 11, 2011): 2 days of vision loss right eye. Wedge suddenly of VA loss OD, too dardkto see through. No flashes or floaters. VA 20/20 OU. SEE INITIAL PHOTOS AND FA FU: 25-year-old woman was seen in the office on September 8, 2011. She about three months ago put on her sunglasses and noticed a smudge in the vision and at that point she noticed the right eye was hazy. She sent out an MRI scan. She had testing done. It was thought at one point she might have MEWDS. She has not had any eye pain. She did have a little cold a week or two before the vision loss, but she didn’t have any fever. She has no focal neurological problems in her past history. She has had no rashes, no shortness of breath, no ulcers, and no health problems. She doesn’t feel sick. She hasn’t had a weight loss. She hasn’t had a weight gain. She does take birth control for the last three years. VISUAL ACUITY: OD 203/0, OS 20/20. IOP: 12 OU. Color vision is normal. SLIT EXAMINATION: Normal with clear lenses. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.0. There is no vitreous cells. The macula looks normal. There is pigment atrophy in the periphery. OS: Vertical C/D ratio is 0.0. There is no vitreous cells. The macula and periphery look healthy. The retinal vessels look normal. Photos confirm clinical findings. FUNDUS AUTO FLUORESCENCE: Shows some decreased fundus auto fluorescence in the periphery. The macula of the right eye there is minimal. The left eye fundus auto fluorescence was normal. SPECTRALIS-SD-OCT SCAN: The OCT scan of the right eye was normal in the very center of the fovea, but there was loss of the photoreceptors in the periphery of the macula and then we did some spot scans in the far periphery and there was some spots in the periphery, which do show up as areas of loss of the deep retinal layers. The left eye OCT scan was completely normal in the macula and the periphery. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows irregular hyperfluorescence, which is only slight in the periphery of the right eye where there is pigment atrophy. There is no evidence of any leakage and there is no evidence of any retinal vasculitis. There is no staining of the retinal vessels nor is there staining of the optic nerve. The left eye fluorescein angiogram was completely normal. The indocyanine green angiogram shows no dark spots in either eye. It does show irregular hyperfluorescence corresponding to the pigment atrophy, which was present on the fluorescein angiogram. IMPRESSION: 1. PROBABLE ACUTE ZONAL OUTER RETINOPATHY (AZOOR IN THE RIGHT EYE) DISCUSSION: I explained to the patient the signs and symptoms were all consistent with AZOOR, which may have some recovery over time and generally is not at least progressive. There are a few blood tests which need to be checked to rule out any sort of systemic inflammatory syndrome or infection that might be an issue. I generally check for syphilis and sarcoid.