Photoreceptor outer segment abnormalities and retinal sensitivity in acute zonal occult outer retinopathy.

PURPOSE

To investigate the relationship between retinal function and photoreceptor abnormalities in eyes with acute zonal occult outer retinopathy.

METHODS

Five patients with acute zonal occult outer retinopathy underwent complete ophthalmologic examination, including spectral-domain optical coherence tomography. Spectral-domain optical coherence tomography findings were compared with retinal sensitivity measured by microperimetry.

RESULTS

Spectral-domain optical coherence tomography images revealed disruptions in the inner segment/outer segment junction line in four of five eyes and disruptions in the outer segment (OS) tip lines in all eyes. Mean retinal sensitivity was 15.1 ± 3.6 dB in the intact OS tip regions and 6.0 ± 6.3 dB in disrupted regions (P < 0.001). In all eyes, disruption of the OS tip lines was also seen in regions of reduced retinal sensitivity, although the inner segment/outer segment was intact. Within the intact inner segment/outer segment regions, mean retinal sensitivity was 7.5 ± 6.7 dB at locations of OS tip disruption and 15.1 ± 3.6 dB at intact OS tip locations (P < 0.001).

CONCLUSION

Structural abnormalities in the photoreceptors were correlated with visual function in eyes with acute zonal occult outer retinopathy. Loss of photoreceptor OS, as indicated by disruptions of the OS tip lines on spectral-domain optical coherence tomography, may represent the primary lesion in acute zonal occult outer retinopathy.