Vitreoretinal Services, Aditya Birla Sankara Nethralaya, 147/1, Mukundapur, E.M. Bypass, Kolkata, West Bengal, India.
Medical and Vision Research Foundations, Sankara Nethralaya, 18, College Road, Sankara Nethralaya, Chennai, Tamil Nadu, India.
Indian J Ophthalmol. 2024 Jul 1;72(7):935-937. doi: 10.4103/IJO.IJO_3228_23. Epub 2024 Mar 8.
Acute Zonal Occult Outer Retinopathy (AZOOR) is characterized by sudden visual impairment, often presenting with scotoma and photopsia in young to middle-aged adults, showing a female predominance. This condition, distinct from genetic disorders like retinitis pigmentosa, lacks a hereditary basis and exhibits unique fundus changes and imaging features indicative of outer retinal dysfunction. Recent advancements have broadened our understanding, identifying variants like Acute Annular Outer Retinopathy (AAOR) and Multizonal outer retinopathy and retinal pigment epitheliopathy (MORR), each with specific clinical presentations and imaging characteristics. The diagnosis of AZOOR and its variants primarily relies on excluding other conditions through comprehensive evaluation, including imaging and serological testing. Treatment approaches, including the use of corticosteroids and immunosuppressives, remain debated, with some evidence suggesting benefits in the early stages. The prognosis of AZOOR varies, with most patients experiencing stabilization, although complications like choroidal neovascularization may occur, requiring targeted therapy. This manuscript elucidates the complexity of AZOOR, emphasizing the necessity of high clinical suspicion and the role of advanced imaging in diagnosis and management.
急性区域性隐匿性外层视网膜病变(AZOOR)的特征是突发性视力障碍,常表现为中青年女性的暗点和闪光感。这种病症与遗传性疾病如色素性视网膜炎不同,没有遗传基础,表现为独特的眼底改变和提示外层视网膜功能障碍的影像学特征。最近的研究进展拓宽了我们的认识,发现了急性环状外层视网膜病变(AAOR)和多区域性外层视网膜和视网膜色素上皮病变(MORR)等变异型,每种变异型都有特定的临床表现和影像学特征。AZOOR 和其变异型的诊断主要依赖于通过全面评估(包括影像学和血清学检查)排除其他病症。治疗方法,包括皮质类固醇和免疫抑制剂的使用,仍存在争议,一些证据表明在早期阶段可能有益。AZOOR 的预后各不相同,大多数患者病情稳定,但可能会出现脉络膜新生血管等并发症,需要进行靶向治疗。本文阐明了 AZOOR 的复杂性,强调了高度临床怀疑的必要性以及高级影像学在诊断和管理中的作用。