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      Clinical Characteristics of Acute Zonal Occult Outer Retinopathy in Chinese Patients

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          Abstract

          Purpose: To review the clinical features of acute zonal occult outer retinopathy (AZOOR) in Chinese patients. Methods: All patients with AZOOR during 2002–2004 in our hospitals were reviewed retrospectively. Results: Seven consecutive Chinese patients with AZOOR were recruited and followed up for 4–18 months. Their age ranged from 26 to 47 years and all were affected bilaterally. They were from the cities near the Pacific Ocean and were used to eating seafood. The common complaints were slightly reduced visual acuity and photopsia. At least one eye of each patient had a visual field defect or decreased local area sensitivity and one patient had bilateral blind spot enlargement. Ten in 14 eyes showed increased numbers of vitreous cells and 4 eyes had anterior chamber inflammatory cells and a keratic precipitate. In their initial examination, minimal or no fundus changes were found, only yellow-white dots or gray dots presented on the deep retina or outer retinal layer. Fundus fluorescent angiography showed large-area depigmentation and hyperfluorescein spots corresponding to fundus findings. Electroretinogram (ERG) or multifocal ERG was abnormal in all eyes with no changes in their follow-up examination. Not all of the initial diagnoses of these patients were consistent with the final ones. Conclusions: AZOOR is not a common disease in China, but easy to misdiagnose. Female predilection, photopsia, visual field defect, ERG abnormality and minimal ophthalmoscopic changes are the common characteristics of AZOOR in Chinese patients. Living habits may play a role in the development of AZOOR.

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          Most cited references 6

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          Acute zonal occult outer retinopathy: a long-term follow-up study1 1InternetAdvance publication at ajo.com June 26, 2002.

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            Collateral damage in acute zonal occult outer retinopathy.

            To evaluate the disease involvement in a patient with acute zonal occult outer retinopathy (AZOOR). Observational case report. A patient with acute zonal occult outer retinopathy was imaged with fundus photography, fluorescein and indocyanine green angiography, and autofluorescence photography. 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. 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.
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              MEWDS, MFC, PIC, AMN, AIBSE, and AZOOR

              (1995)
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                Author and article information

                Journal
                OPH
                Ophthalmologica
                10.1159/issn.0030-3755
                Ophthalmologica
                S. Karger AG
                0030-3755
                1423-0267
                2008
                May 2008
                22 May 2008
                : 222
                : 3
                : 149-156
                Affiliations
                aEye Hospital Affiliated to Wenzhou Medical College, Wenzhou, bJinan Eye Hospital, Jinan, and cRetina Department, Shenzhen Eye Hospital, Shenzhen, China
                Article
                126076 Ophthalmologica 2008;222:149–156
                10.1159/000126076
                18497522
                © 2008 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 4, Tables: 3, References: 20, Pages: 8
                Categories
                Original Paper

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