To assess retinal morphology in acute zonal occult outer retinopathy (AZOOR) without ophthalmoscopically visible fundus changes. Retrospective case series. Two consecutive patients with bilateral AZOOR with photopsia corresponding to areas of visual field loss and a normal fundus appearance were examined using optical coherence tomography (OCT), automated perimetry and electroretinography (ERG). Both patients demonstrated photoreceptor atrophy corresponding to partial or complete scotomata with reduced or extinct electroretinographic responses. Attenuation or complete loss of all the segments composing the photoreceptor layer was found by OCT. Full-field ERG revealed affection of the 30 Hz flicker responses and subnormal photopic responses in both patients and subnormal scotopic responses in case 1. Multifocal electroretinography (mERG) revealed localized outer retinal dysfunction. The field loss was more extensive than the area of photoreceptor loss. Photoreceptor atrophy can be demonstrated in AZOOR without ophthalmoscopically visible fundus lesions.
- Acute zonal occult outer retinopathy
- Optical coherence tomography
- Photoreceptor atrophy