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Acute Zonal Occult Outer Retinopathy: Diagnosis and Differential Diagnosis in Different Types |
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作者:SongZong… 文章来源:Eye Hospital, Wenzhou Medical College 点击数1342 更新时间:2005/6/14 23:17:47 文章录入:szmeyes 责任编辑:毛进 |
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Purpose To investigate the clinical features, diagnosis and differential diagnosis of acute zonal occult outer retinopathy (AZOOR).
Methods All patients with AZOOR during 2002-2004 in our hospitals were reviewed retrospectively. Ophthalmic examination, fundus fluorescent angiograph (FFA), visual electrophysiology and perimetry were performed. Other examinations including blood routine test, immunologic system and neurological examinations were also evaluated.
Results Seven consecutive patients (6 female, 1 male) with AZOOR were recruited and followed up for 4 to18 months. Their age ranged from 26 to 47 years and all were affected bilaterally. The common complaints were slightly reduced visual acuity and photopsia. At least one eye of each patient had visual field defect or decreased local area sensitivity and one patient had bilateral blind-spot enlargement. Ten in fourteen eyes had various degrees of vitreous cells and four eyes had anterior chamber inflammatory cells and keratic precipitate. Minimal or no fundus changes were found in their initial examination, only yellow-white dots (4/14 eyes) or gray dots (8/12eyes) presented on the deep retina or retinal pigment epithelium-Bruch membrane-choroid capillary complex layer. FFA showed large area depigmentation (2/14 eyes) and hyperfluorescein spots (12/14 eyes) corresponding to fundus findings. Electroretinogram or multiple elctroretinogram showed abnormal in all of eyes with no changes in their follow-up examination. All of the initial diagnoses of these patients were not consistent with the final diagnosis.
Conclusions Female predilection, photopsia, visual field defect, ERG abnormality and minimal ophthalmoscopic changes are the common characters of AZOOR. Differential diagnosis of AZOOR is complicate and easily misdiagnosed
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