Kitakawa Takaaki, Hayashi Takaaki, Takashina Hirotsugu, Mitooka Katsuya, Gekka Tamaki, Tsuneoka Hiroshi
Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan.
Doc Ophthalmol. 2012 Jun;124(3):249-54. doi: 10.1007/s10633-012-9318-1. Epub 2012 Mar 9.
The purpose of this study was to report a patient with acute zonal occult outer retinopathy (AZOOR) unilaterally, who received steroid pulse therapy. A 42-year-old woman presented with photopsias and severe vision loss in her left eye. Visual acuity was 0.04, and Humphrey visual field testing showed overall depression with a mean deviation (MD) value of -25.78 dB in the left eye. Fundus and angiographic examinations found no specific abnormal findings, leading to a diagnosis of AZOOR. Optical coherence tomography showed attenuation of the photoreceptor inner segment/outer segment junction (IS/OS) line. Focal macular electroretinography (fmERG) demonstrated that there were non-detectable responses at 5°, 10° and 15° (in diameter). Following steroid pulse therapy, her visual acuity was 1.0, her MD value improved to -16.08 dB, and there were both partial recovery of the IS/OS line and apparent improvements of fmERG responses (at 10° and 15°). The present findings suggest that steroid pulse therapy might potentially be an effective treatment in some AZOOR patients.
本研究的目的是报告一例接受类固醇脉冲疗法的单侧急性区域性隐匿性外层视网膜病变（AZOOR）患者。一名42岁女性因左眼出现闪光感和严重视力丧失前来就诊。视力为0.04，Humphrey视野检查显示左眼整体缺损，平均缺损（MD）值为-25.78 dB。眼底和血管造影检查未发现特异性异常表现，诊断为AZOOR。光学相干断层扫描显示光感受器内节/外节连接（IS/OS）线衰减。黄斑区局部视网膜电图（fmERG）显示在5°、10°和15°（直径）处无反应。类固醇脉冲治疗后，她的视力为1.0，MD值改善至-16.08 dB，IS/OS线部分恢复，fmERG反应（在10°和15°处）明显改善。目前的研究结果表明，类固醇脉冲疗法可能是部分AZOOR患者的有效治疗方法。
