Acute zonal occult outer retinopathy in a patient with graft-versus-host disease.
OBJECTIVE
To investigate the mechanism of bilateral central vision loss in a patient with graft-versus-host disease.


METHODS
Observational case report.


METHODS
A 43-year-old man with graft-versus-host disease developed acute painless progressive central vision loss, first in the left eye and then in the right. The patient underwent slit-lamp biomicroscopy, indirect ophthalmoscopy, fluorescein angiography, visual field testing, full-field electroretinography, multifocal electroretinography, and testing for paraneoplastic antibodies.


RESULTS
Fundus examination and fluorescein angiography were unremarkable. Goldmann perimetry revealed enlarged blind spots with central scotomas bilaterally. An electroretinogram testing showed asymmetric retinal dysfunction, consistent with acute zonal occult outer retinopathy. No paraneoplastic autoantibodies were detected. The patient continued to have asymmetric progressive vision loss that stabilized over the next 6 months.


CONCLUSIONS
Graft-versus-host disease should be included in the autoimmune conditions associated with AZOOR.
Cheung
Marsha C
MC
Department of Ophthalmology, University of California, San Francisco, CA, USA.
Nune
George C
GC
Hwang
David G
DG
Sutter
Erich E
EE
Duncan
Jacque L
JL
D000208:Acute Disease; D000328:Adult; D004596:Electroretinography; D005451:Fluorescein Angiography; D006086:Graft vs Host Disease / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D009887:Ophthalmoscopy; D012164:Retinal Diseases / Q000175:diagnosis / Q000209:etiology*; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology*; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields