Acute zonal occult outer retinopathy in patients with multiple evanescent white dot syndrome.
OBJECTIVE
To describe cases of acute zonal occult outer retinopathy (AZOOR) in patients previously diagnosed as having multiple evanescent white dot syndrome (MEWDS).


METHODS
In a retrospective case series, we studied fundus photographs, fundus autofluorescence images, optical coherence tomographic scans, fluorescein and indocyanine green angiograms, visual fields, and results of electroretinography.


RESULTS
Three patients diagnosed as having MEWDS developed clinical, angiographic, autofluorescence, visual field, and/or electrophysiologic evidence of AZOOR. Spectral domain optical coherence tomographic findings disclosed attenuation of the photoreceptor inner segment-outer segment junction in areas of AZOOR involvement. In 1 patient, hyperautofluorescence on fundus autofluorescence images during the MEWDS episode coincided with the area of involvement of AZOOR.


CONCLUSIONS
Development of AZOOR may occur in patients with MEWDS, suggesting that the conditions may share a common genetic susceptibility and/or pathogenetic factor. Although the typical visual prognosis after MEWDS is excellent, subsequent diagnosis of AZOOR may portend a worse outcome.
Fine
Howard F
HF
LuEsther T Mertz Retina Research Laboratory, Manhattan Eye, Ear, and Throat Hospital, New York, New York, USA. hffine@gmail.com
Spaide
Richard F
RF
Ryan
Edwin H
EH
Matsumoto
Yoko
Y
Yannuzzi
Lawrence A
LA
D000208:Acute Disease; D000328:Adult; D001284:Atrophy; D004396:Coloring Agents; D004596:Electroretinography; D005260:Female; D005451:Fluorescein Angiography; D005453:Fluorescence; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D010781:Photography; D012164:Retinal Diseases / Q000150:complications* / Q000175:diagnosis; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D012189:Retrospective Studies; D013577:Syndrome; D041623:Tomography, Optical Coherence; D014794:Visual Fields
D004396:Coloring Agents; D007208:Indocyanine Green