Manifestations of acute regional occult outer retinopathy in full-field electroretinogram_Chinese Journal of Ocular Fundus Diseases

Authors：

 Bao Li , Yang Tao , Wang Xiaoyue

Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu 610041, China;

Corresponding author：

Bao Li, Email: 471134976@qq.com

Keywords：

Retinal diseases; Visual field tests; Electroretinography

DOI：

10.3760/cma.j.cn511434-20200604-00262

Video：

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Objective To observe the full-field ERG (ff-ERG) characteristics of patients with acute regional occult outer retinopathy (AZOOR).Methods A retrospective observational study. From June 2017 to June 2019, 62 eyes of 42 patients (AZOOR group) who were diagnosed with AZOOR in the Department of Ophthalmology of West China Hospital of Sichuan University were included in the study. All patients had no obvious localized disease on the fundus. Among 62 eyes, BCVA of 16 eyes were＜0.1, BCVA of 27 eyes were ≤0.5, and BCVA of 19 eyes were＞0.5. From June 2018 to January 2019, 40 normal volunteers (80 eyes) who attended the outpatient clinic of West China Hospital of Sichuan University and passed detailed ophthalmological examination to exclude all eye diseases including refractive errors were selected as the normal control group. All the examined eyes were tested with ff-ERG using the German Roland visual electrophysiological inspection system. The peak times and amplitudes of the waveforms induced by each response of dark adaptation 0.01 ERG, dark adaptation 3.0 ERG, dark adaptation 3.0 ERG, light adaptation 3.0 ERG, and light adaptation 30 Hz flicker ERG were recorded, respectively. The peak time and amplitude of each ff-ERG response between the two groups were compared by independent sample t test. The peak time and amplitude of each ff-ERG response between different BCVA eyes in the AZOOR group were compared by variance test.Results Compared with the normal control group, 0.01 ERG b wave of the dark adaptation of AZOOR group (t=3.601, －6.120), 3.0 ERG a wave and b wave of dark adaptation (t=2.627, －4.263, 3.719, －5.866), 3.0 Oscillation potential P2 wave of dark adaptation (t=－6.625), 3.0 ERG a wave and b wave of bright adaptation (t=3.762, －3.612, 3.648, －3.739) and 30 Hz flicker ERG P wave of bright adaptation (t=－3.832), all peak time of those were significantly delayed, the amplitude decreased, and the difference was statistically significant (P＜0.05). Comparison of different BCVA eyes in the AZOOR group showed that 0.01 ERG b wave amplitude of dark adaptation (F=3.950), 3.0 ERG a peak and b wave amplitude of dark adaptation (F=4.408, 4.876), oscillation potential P2 wave amplitude of dark adaptation (F=4.295), 3.0 ERG b wave amplitude of bright adaptation (F=4.344) and 30 Hz flicker ERG P wave amplitude of bright adaptation (F=4.483) of differences were statistically significant (P＜0.05). There was no statistically significant difference in waveform peak time and amplitude of the other reactions (P＞0.05). Pairwise comparison results showed that, compared with those with 0.1≤BCVA≤0.5 and BCVA＞0.5, those with BCVA＜0.1 dark adaptation to 0.01 ERG b wave, dark adaptation 3.0 ERG b wave, dark adaptation oscillation potential P2 wave, and light adaptation 3.0 ERG b wave and light adaptation 30 Hz scintillation ERG P wave amplitude were significantly reduced, and dark adaptation to 3.0 ERG a peak was significantly delayed, the difference was statistically significant (P＜0.05).Conclusions The ff-ERG of patients with AZOOR show delayed peak time and decreased amplitude of each response. The worse BCVA are accompanied by the more obvious decrease of each response amplitude of ff-ERG.

Citation： Bao Li, Yang Tao, Wang Xiaoyue. Manifestations of acute regional occult outer retinopathy in full-field electroretinogram. Chinese Journal of Ocular Fundus Diseases, 2020, 36(11): 833-837. doi: 10.3760/cma.j.cn511434-20200604-00262 Copy

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8.	Kure K, Obata R, Inoue Y, et al. Acute progression of electrophysiologically affected fellow eye in unilaterally symptomatic acute zonal occult outer retinopathy[J]. Clin Ophthalmol, 2011, 5: 1167-1170. DOI: 10.2147/OPTH.S23207.
9.	Francis PJ, Marinescu A, Fitzke FW, et al. Acute zonal occult outer retinopathy: towards a set of diagnostic criteria[J]. Br J Ophthalmol, 2005, 89(1): 70-73. DOI: 10.1136/bjo.2004.042416.
10.	Piao CH, Kondo M, Ishikawa S, et al. A case of unusual retinopathy showing features similar to acute zonal occult outer retinopathy associated with negative electroretinograms[J]. Jpn J Ophthalmol, 2007, 51(1): 69-71. DOI: 10.1007/s10384-006-0391-4.
11.	朱彩红, 张士胜, 王康孙. 急性区域性隐匿性外层视网膜病变[J]. 国外医学眼科学分册, 2005, 29(6): 399-403. DOI: 10.3760/cma.j.issn.1673-5803.2005.06.012.Zhu CH, Zhang SS, Wang KS. Acute zonal occult outer retinopathy[J]. Section Ophthalmol Foreign Med Sci, 2005, 29(6): 399-403. DOI: 10.3760/cma.j.issn.1673-5803.2005.06.012.

1. Gass JD. Acute zonal occult outer retinopathy. Donders Lecture: The Netherlands Ophthalmological Society, Maastricht, Holland, June 19, 1992[J]. J Clin Neuroophthalmol, 1993, 13(2): 79-97.
2. 宋宗明, 盛艳娟, 陈青山, 等. 急性区域性隐匿性外层视网膜病变的诊断和鉴别诊断[J]. 中华眼科杂志, 2006, 42(8): 717-723. DOI: 10.3760/j:issn:0412-4081.2006.08.010.Song ZM, Sheng YJ, Chen QS, et al. Diagnosis and differential diagnosis of acute zonal occult outer retinopathy[J]. Chin J Ophthalmol, 2006, 42(8): 717-723. DOI: 10.3760/j:issn:0412-4081.2006.08.010.
3. 陈倩, 常青, 王文吉, 等. 18例急性区域性隐匿性外层视网膜病变的临床分析[J]. 中华眼底病杂志, 2012, 28(4): 363-367. DOI: 10.3760/cma.j.issn.1005-1015.2012.04.012.Chen Q, Chang Q, Wang WJ, et al. Clinical analysis of 18 patients with acute zonal occult outer retinopathy[J]. Chin J Ocul Fundus Dis, 2012, 28(4): 363-367. DOI: 10.3760/cma.j.issn.1005-1015.2012.04.012.
4. Monson DM, Smith JR. Acute zonal occult outer retinopathy[J]. Surv Ophthalmol, 2001, 56(1): 23-35. DOI: 10.1016/j.survophthal.2010.07.004.
5. Robson AG, Nilsson J, Li S, et al. ISCEV guide to visual electrodiagnostic procedures[J]. Doc Ophthalmol, 2018, 136(1): 1-26. DOI: 10.1007/s10633-017-9621-y.
6. Gass JD, Agarwal A, Scott IU. Acute zonal occult outer retinopathy: a long-term follow-up study[J]. Am J Ophthalmol, 2002, 134(3): 329-339. DOI: 10.1016/S0002-9394(02)01640-9.
7. Tomas S, Harpal S, Leona W, et al. Acute zonal cone photoreceptor outer segment loss[J]. JAMA Ophthalmol, 2017, 135(5): 1-4. DOI: 10.1001/jamaophthalmol.2017.0451.
8. Kure K, Obata R, Inoue Y, et al. Acute progression of electrophysiologically affected fellow eye in unilaterally symptomatic acute zonal occult outer retinopathy[J]. Clin Ophthalmol, 2011, 5: 1167-1170. DOI: 10.2147/OPTH.S23207.
9. Francis PJ, Marinescu A, Fitzke FW, et al. Acute zonal occult outer retinopathy: towards a set of diagnostic criteria[J]. Br J Ophthalmol, 2005, 89(1): 70-73. DOI: 10.1136/bjo.2004.042416.
10. Piao CH, Kondo M, Ishikawa S, et al. A case of unusual retinopathy showing features similar to acute zonal occult outer retinopathy associated with negative electroretinograms[J]. Jpn J Ophthalmol, 2007, 51(1): 69-71. DOI: 10.1007/s10384-006-0391-4.
11. 朱彩红, 张士胜, 王康孙. 急性区域性隐匿性外层视网膜病变[J]. 国外医学眼科学分册, 2005, 29(6): 399-403. DOI: 10.3760/cma.j.issn.1673-5803.2005.06.012.Zhu CH, Zhang SS, Wang KS. Acute zonal occult outer retinopathy[J]. Section Ophthalmol Foreign Med Sci, 2005, 29(6): 399-403. DOI: 10.3760/cma.j.issn.1673-5803.2005.06.012.

Chinese Journal of Ocular Fundus Diseases

Manifestations of acute regional occult outer retinopathy in full-field electroretinogram

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