{"title":"Clinical manifestation and multimodal images of Chinese acute zonal occult outer retinopathy patients.","authors":"Shu-Lin Liu, Xin-Yu Zhao, Jing-Yuan Yang, You-Xin Chen","doi":"10.18240/ijo.2025.10.14","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>To comprehensively examine the clinical presentations, multimodal images, and long-term follow-up of Chinese patients with acute zonal occult outer retinopathy (AZOOR), a rare inflammatory disorder.</p><p><strong>Methods: </strong>This was a retrospective study. A total of 20 patients (32 eyes) were included. The medical records and multimodal imaging, including wide-field fundus photography, wide-field fundus autofluorescence (FAF), and swept-source optical coherence tomography (SS-OCT) were analyzed.</p><p><strong>Results: </strong>The study included 20 patients with a mean age of 38.2±10.9y, and females accounted for 60%. Lesions could involve peripapillary areas, macular region, and peripheral retina. The mean best-corrected visual acuity (BCVA) at presentation was 0.38±0.60 logMAR, with no significant difference in visual acuity between acute cases (within 6mo of onset) and chronic cases (beyond 6mo of onset; <i>P</i>=0.390). There was no statistically significant difference in visual acuity between eyes of acute case (within 6mo of onset) and the chronic case (beyond 6mo of onset). In some chronic case, FAF examination revealed the presence of a hyperautofluorescent (hyperAF) ring around the macular area (6/18), a phenomenon not observed in the acute case (<i>P</i>=0.024). A higher proportion of chronic cases showed predominantly hypoautofluorescent (hypoAF) lesions compared to the acute case (13/18 <i>vs</i> 2/14, <i>P</i>=0.0016). SS-OCT examination showed that both acute and chronic cases exhibited hyperreflective dots above the retinal pigment epithelium (RPE), and ellipsoid zone (EZ) and RPE damage. In the chronic case, eyes with hyperreflective dots above the RPE were more likely to exhibit EZ and RPE damage in the macular region compared to those without these dots.</p><p><strong>Conclusion: </strong>Multimodal imaging plays a crucial role in the follow-up of patients with AZOOR. In chronic cases of AZOOR, the presence of hyperreflective dots above the RPE indicates a higher likelihood of outer retinal involvement in the macular region. This study provides critical insights into the complex presentation and progression of AZOOR.</p>","PeriodicalId":14312,"journal":{"name":"International journal of ophthalmology","volume":"18 10","pages":"1914-1921"},"PeriodicalIF":1.8000,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454004/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.18240/ijo.2025.10.14","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Aim: To comprehensively examine the clinical presentations, multimodal images, and long-term follow-up of Chinese patients with acute zonal occult outer retinopathy (AZOOR), a rare inflammatory disorder.
Methods: This was a retrospective study. A total of 20 patients (32 eyes) were included. The medical records and multimodal imaging, including wide-field fundus photography, wide-field fundus autofluorescence (FAF), and swept-source optical coherence tomography (SS-OCT) were analyzed.
Results: The study included 20 patients with a mean age of 38.2±10.9y, and females accounted for 60%. Lesions could involve peripapillary areas, macular region, and peripheral retina. The mean best-corrected visual acuity (BCVA) at presentation was 0.38±0.60 logMAR, with no significant difference in visual acuity between acute cases (within 6mo of onset) and chronic cases (beyond 6mo of onset; P=0.390). There was no statistically significant difference in visual acuity between eyes of acute case (within 6mo of onset) and the chronic case (beyond 6mo of onset). In some chronic case, FAF examination revealed the presence of a hyperautofluorescent (hyperAF) ring around the macular area (6/18), a phenomenon not observed in the acute case (P=0.024). A higher proportion of chronic cases showed predominantly hypoautofluorescent (hypoAF) lesions compared to the acute case (13/18 vs 2/14, P=0.0016). SS-OCT examination showed that both acute and chronic cases exhibited hyperreflective dots above the retinal pigment epithelium (RPE), and ellipsoid zone (EZ) and RPE damage. In the chronic case, eyes with hyperreflective dots above the RPE were more likely to exhibit EZ and RPE damage in the macular region compared to those without these dots.
Conclusion: Multimodal imaging plays a crucial role in the follow-up of patients with AZOOR. In chronic cases of AZOOR, the presence of hyperreflective dots above the RPE indicates a higher likelihood of outer retinal involvement in the macular region. This study provides critical insights into the complex presentation and progression of AZOOR.
目的:综合分析我国急性区域性隐匿性外视网膜病变(AZOOR)患者的临床表现、多模式影像及长期随访。方法:回顾性研究。共纳入20例患者(32只眼)。分析病历及多模态成像,包括宽视场眼底摄影、宽视场眼底自体荧光(FAF)和扫源光学相干断层扫描(SS-OCT)。结果:纳入患者20例,平均年龄38.2±10.9岁,女性占60%。病变可累及乳头周围区、黄斑区和周围视网膜。平均最佳矫正视力(BCVA)为0.38±0.60 logMAR,急性(发病后6个月以内)和慢性(发病后6个月以上)患者的视力无显著差异,P=0.390。急性病例(发病6个月以内)与慢性病例(发病6个月以上)双眼视力差异无统计学意义。在一些慢性病例中,FAF检查显示黄斑区域周围存在高自荧光(hyperauto萤光)环(6/18),在急性病例中未观察到这种现象(P=0.024)。与急性病例相比,慢性病例主要表现为低自身荧光(hypoAF)病变的比例更高(13/18 vs 2/14, P=0.0016)。SS-OCT检查显示,急性和慢性病例均表现为视网膜色素上皮(RPE)上方的高反射点,以及椭球区(EZ)和RPE损伤。在慢性病例中,在RPE上方有高反射点的眼睛比没有这些点的眼睛更容易在黄斑区域出现EZ和RPE损伤。结论:多模态影像学在AZOOR患者的随访中起着至关重要的作用。在慢性AZOOR病例中,RPE上方出现的高反射点表明黄斑区域外视网膜受累的可能性更高。这项研究为AZOOR的复杂表现和进展提供了重要的见解。
期刊介绍:
· International Journal of Ophthalmology-IJO (English edition) is a global ophthalmological scientific publication
and a peer-reviewed open access periodical (ISSN 2222-3959 print, ISSN 2227-4898 online).
This journal is sponsored by Chinese Medical Association Xi’an Branch and obtains guidance and support from
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Chinese Academy of Engineering.
International Scientific Advisors include Prof. Serge Resnikoff (WHO Senior Speciatist for Prevention of
blindness), Prof. Chi-Chao Chan (National Eye Institute, USA) and Prof. Richard L Abbott (Ex-President of
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Honorary Editors-in-Chief: Prof. Li-Xin Xie(Academician of Chinese Academy of
Engineering/Honorary President of Chinese Ophthalmological Society); Prof. Dennis Lam (President of APAO) and
Prof. Xiao-Xin Li (Ex-President of Chinese Ophthalmological Society).
Chief Editor: Prof. Xiu-Wen Hu (President of IJO Press).
Editors-in-Chief: Prof. Yan-Nian Hui (Ex-Director, Eye Institute of Chinese PLA) and
Prof. George Chiou (Founding chief editor of Journal of Ocular Pharmacology & Therapeutics).
Associate Editors-in-Chief include:
Prof. Ning-Li Wang (President Elect of APAO);
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Prof.Joel Schuman (President of Association of University Professors of Ophthalmology,USA);
Prof.Yizhi Liu (Vice President of Chinese Ophtlalmology Society);
Prof.Yu-Sheng Wang (Director of Eye Institute of Chinese PLA);
Prof.Ling-Yun Cheng (Director of Ocular Pharmacology, Shiley Eye Center, USA).
IJO accepts contributions in English from all over the world. It includes mainly original articles and review articles,
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