Kuo Yi Chun, Chen Nancy, Tsai Rong Kung
Department of Ophthalmology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
Institute of Eye Research, Buddhist Tzu Chi General Hospital, Tzu Chi University, 707, Sec. 3, Chung-Yang Rd., Hualien, 970, Taiwan.
BMC Ophthalmol. 2017 Dec 6;17(1):236. doi: 10.1186/s12886-017-0638-5.
AZOOR was first described by Gass in 1993 as a syndrome with rapid loss of one or more extensive zones of the outer retinal segments. It is characterized by photopsia, minimal funduscopic changes, and electroretinographic abnormalities. The efficacy of systemic steroids in treating AZOOR has been previously described and advocated by the concept of autoimmune retinopathy. However, the use of intravitreal of sustained-released steroid had not been mentioned to date.
A 34-year-old man had sudden onset of central scotoma and photopsia in the left eye. His visual acuity continued deteriorating. The visual field defect demonstrated bilateral enlarged blind spots and altitudinal defects. Fluorescein angiography (FA) showed nonspecific retinal inflammation, and an electroretinogram (ERG) illustrated decreased amplitude of the b wave in both eyes. Optical coherence tomography (OCT) examinations revealed parafoveal loss of the photoreceptor inner/outer segment (IS/OS) junction. Therefore, acute zonal occult outer retinopathy (AZOOR) was diagnosed. Although his vision did not improve under the initial treatment of systemic corticosteroid and calcium channel blocker, remarkable improvement was noticed after the intravitreal injection(IVI) of Ozurdex, consistent with the recovered IS/OS junction disruption.
We herein report a typical case of AZOOR, suggesting that the intravitreal injection of steroid may benefit in certain patients.
急性区域性隐匿性外层视网膜病变（AZOOR）于1993年首次由加斯描述为一种伴有一个或多个广泛的外层视网膜节段快速丧失的综合征。其特征为闪光感、眼底改变轻微以及视网膜电图异常。全身应用类固醇治疗AZOOR的疗效此前已有描述，并基于自身免疫性视网膜病变的概念得到提倡。然而，迄今为止尚未提及玻璃体内注射缓释类固醇的应用。
一名34岁男性左眼突然出现中心暗点和闪光感。其视力持续下降。视野缺损显示双侧盲点扩大和象限性缺损。荧光素血管造影（FA）显示非特异性视网膜炎症，视网膜电图（ERG）显示双眼b波振幅降低。光学相干断层扫描（OCT）检查显示黄斑旁光感受器内/外节（IS/OS）连接中断。因此，诊断为急性区域性隐匿性外层视网膜病变（AZOOR）。尽管在初始全身应用皮质类固醇和钙通道阻滞剂治疗下其视力未改善，但在玻璃体内注射（IVI）奥曲肽后视力显著改善，并与恢复的IS/OS连接中断情况相符。
我们在此报告一例典型的AZOOR病例，提示玻璃体内注射类固醇可能对某些患者有益。
