A patient with a history of photopsias in the left eye for approximately 20 years comes for evaluation due to photopsias now involving both eyes. Concomitantly, the patient also notices scotomas in both eyes. Infectious, immune, and degenerative retinopathy workup was negative. Based on the clinical appearance of retinopathy, a diagnosis of Acute Zonal Occult Outer Retinopathy was made. Fundus autofluorescence showed pathognomonic trizonal degeneration in both eyes. Optical coherence tomography and Indocyanine green angiography confirmed such findings. For years, the patient remained with stable visual acuity and minimal lesion progression on multimodal imaging until significant lesion progression occurred more prominently in the left eye affecting the foveal area and compromising his central visual acuity. We have also evaluated two similar cases and assessed the lesions progression by measuring the largest diameter area on AF optos widefield imaging. Based on our 3 cases, the average yearly AZOOR lesion progression rate was 1.01mm. More studies are needed in order to assess the rate of lesion progression in these patients. Despite slow progression, there can be rapid episodic progression, as noted in our patient.
Presentation Date: 03/02/2023
Issue Date: 03/17/2023