Two types of acute zonal occult outer retinopathy differentiated by dark- and light-adapted perimetry

Jpn J Ophthalmol. 2014 Mar;58(2):177-87. doi: 10.1007/s10384-013-0297-x. Epub 2013 Dec 26.


Purpose: To assess the results of perimetry recorded under dark- and light-adapted (DA and LA) conditions in patients with acute zonal occult outer retinopathy (AZOOR) and to compare the results of electroretinography (ERG) and spectral-domain optical coherence tomography (SD-OCT) in two groups of AZOOR patients.

Methods: Twelve patients with AZOOR were studied. The diagnosis of AZOOR was based on the results of ophthalmoscopy, Goldmann kinetic perimetry, and multifocal ERGs. In addition, DA and LA perimetry, ERG, and SD-OCT were performed. The patients were followed for 1-9 years.

Results: The patients were classified into two types: type A patients (3) had a scotoma detected by both DA and LA perimetry, normal or equally abnormal cone and rod ERGs, atrophy of the outer nuclear layer (ONL), and disruption of the inner segment/outer segment (IS/OS) junction line in the OCT images. Type B patients (7) had a scotoma that was more prominent in LA than in DA perimetry and a continuous IS/OS junction line in the OCT images. Two patients had characteristics of both type A and type B AZOOR.

Conclusions: Our findings suggest that eyes with type A AZOOR have focal and severe impairment of both the rods and cones, and eyes with type B AZOOR have focal and specific impairment of the cones.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Atrophy
  • Dark Adaptation*
  • Diagnosis, Differential
  • Electroretinography
  • Female
  • Follow-Up Studies
  • Humans
  • Light
  • Male
  • Middle Aged
  • Ophthalmoscopy
  • Photoreceptor Cells, Vertebrate / pathology
  • Retinal Photoreceptor Cell Inner Segment / pathology
  • Retinal Photoreceptor Cell Outer Segment / pathology
  • Scotoma / classification
  • Scotoma / diagnosis*
  • Tomography, Optical Coherence
  • Visual Field Tests / methods*
  • Visual Fields
  • White Dot Syndromes

Supplementary concepts

  • Acute zonal occult outer retinopathy