title: An optical coherence tomography and fundus autofluorescence imaging study of peripapillary acute zonal occult outer retinopathy.
abstract: OBJECTIVE
  To evaluate peripapillary acute zonal occult outer retinopathy in a 67-year-old man.
  
  
  METHODS
  Images were obtained using fundus photography, fluorescein angiography (FA) and indocyanine green angiography (ICGA), fundus autofluorescence (FAF) imaging, and optical coherence tomography (OCT). Visual field testing and multifocal electroretinogram (mfERG) were also performed to evaluate retinal function.
  
  
  RESULTS
  Fundus photographs showed subtle pigmentary changes in the peripapillary region, while FAF imaging showed clearly defined hypofluorescent areas in the peripapillary region. Intense hyperfluorescent lesions were also seen underneath hypofluorescent areas. A transmission defect with a granular hyperfluorescence was visible on FA, and ICGA showed hypofluorescence within the lesion. The outer border of the peripapillary zone appeared to block the underlying choroidal fluorescence. The photoreceptor inner segment/outer segment line was absent on OCT images from this area in both eyes, and hyperreflective punctate drusen-like materials were present at the outer border of the peripapillary zone. Visual field testing by Goldmann perimetry showed blind-spot enlargement, and mfERG showed corresponding amplitude reductions.
  
  
  CONCLUSIONS
  We speculate that the intense hyperautofluorescent material at the outer border of the peripapillary zone might be accumulated drusenoid lipofuscin.
authors: Department of Ophthalmology, Jichi Medical University, Tochigi, Japan.
authors: Shinji
authors: S
authors: Makino
authors: Yoshiaki
authors: Y
authors: Tanaka
authors: Hironobu
authors: H
authors: Tampo
keywords: Acute zonal occult outer retinopathy; Fluorescein angiography; Fundus autofluorescence imaging; Indocyanine green angiography; Multifocal electroretinogram; Optical coherence tomography; Visual field