Multimodal imaging in AZOOR: a case report
Acute zonal occult outer retinopathy (AZOOR) was first described as an acute onset VF defect with or without photopsias due to outer retinal dysfunction. It is an idiopathic disorder whose demography, clinical features, and outcomes are different in Asians when compared with Caucasians. The following case has been reported in the Indian Journal of Ophthalmology.

A 24-year-old male presented with a temporal field defect in his right eye (RE) since 1 month. There was no associated photopsia, redness, pain, and no preceding viral illness. Unaided visual acuity (UAVA) was 6/6 in both eyes (BE). Anterior segment examination, pupillary reflexes, and fundus examination of the left eye (LE) were unremarkable.

Fundus examination of the RE revealed a hypopigmented amoeboid lesion in the peripapillary area extending upto the nasal margin of the fovea [Figure 1]. RE fundus autofluorescence (AF) showed stippled hypo- and hyper AF with a hyper AF transition zone between the involved and uninvolved retina.

Humphrey's visual field (VF) testing revealed a temporal hemianopic defect in the RE. Spectral domain optical coherence tomography showed absence of ellipsoid and interdigitation zones in the area of the lesion with normal inner retinal and choroidal architecture. While fluorescein angiography showed transmission fluorescence.

Multimodal imaging (MMI) of the LE was normal. Clinical diagnosis of RE acute zonal occult outer retinopathy (AZOOR) was made and the patient was subjected to full-field electroretinogram (ERG).

RE ERG revealed increased latency and significantly reduced amplitude of 30 Hz flicker response, suggestive of generalized cone dysfunction. The patient refused to take oral steroids, and at 6 months follow-up, he was maintaining a UAVA of 6/6 with no change in MMI.

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