title: Collateral damage in acute zonal occult outer retinopathy.
abstract: OBJECTIVE
  To evaluate the disease involvement in a patient with acute zonal occult outer retinopathy (AZOOR).
  
  
  METHODS
  Observational case report.
  
  
  METHODS
  A patient with acute zonal occult outer retinopathy was imaged with fundus photography, fluorescein and indocyanine green angiography, and autofluorescence photography.
  
  
  RESULTS
  There was subtle depigmentation in the central portion of the lesion with a drusen-like deposit at the outer border. Fluorescein angiography showed a transmission defect centrally and a blocking defect at the border where the drusenoid material accumulated. Autofluorescent photography demonstrated that the drusenoid material was intensely autofluorescent, consistent with the presence of lipofuscin, and the central portion of the lesion showed atrophy of the retinal pigment epithelium. Indocyanine green angiography showed atrophy of the choriocapillaris underlying areas of atrophy of the retinal pigment epithelium.
  
  
  CONCLUSIONS
  In this case acute zonal occult outer retinopathy caused an area of retinal pigment epithelium cell death with lipofuscin-laden cells at the border of the expanding lesion and associated atrophy of the underlying choriocapillaris.
authors.affiliation: Vitreous-Retina-Macula Consultants of New York, New York, USA. VRMNY@aol.com
authors.forename: Richard F
authors.initials: RF
authors.lastname: Spaide
mesh_terms: D000208:Acute Disease; D001284:Atrophy; D001327:Autoimmune Diseases / Q000150:complications; D016923:Cell Death; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D007208:Indocyanine Green; D008062:Lipofuscin / Q000378:metabolism; D008875:Middle Aged; D010781:Photography; D010857:Pigment Epithelium of Eye / Q000378:metabolism / Q000473:pathology*; D012164:Retinal Diseases / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism
chemical_list: D004396:Coloring Agents; D008062:Lipofuscin; D007208:Indocyanine Green