Acute Zonal Occult Outer Retinopathy (AZOOR)

A patient with a history of asthma and migraines presented to the Bascom Palmer emergency room with complaints of photopsias and central blurred vision in both eyes. Vision was 20/20 in both eyes with normal intraocular pressures. Anterior segment exam was unremarkable. Dilated fundus exam revealed peripapillary changes of the right eye with an otherwise normal fundus. Gray chorioretinal lesions were noted inferotemporally in the left eye. Humphrey visual field revealed an enlarged blindspot in the right eye. A hyperautofluoresecent ring surrounding the optic nerve was identified on fundus autofluorescence of the right eye. The area within the ring corresponded to a window defect on fluorescein angiography. The left eye exhibited early staining with late leakage of the inferotemporal lesions. The patient was diagnosed with AZOOR and trialed on a short course of prednisone per oral for three months. Over four years of follow-up, the patient had one recurrence in the right eye. At the most recent visit she described resolution of symptoms and had a best corrected visual acuity of 20/20 in both eyes.

Presentation Date: 03/04/2021

Issue Date: 04/02/2021