Objective To investigate the clinical manifestations and spectral-domain optical coherence tomography (SD-OCT) imaging features of acute zonal occult outer retinopahy (AZOOR) and to explore the role of SD-OCT in the diagnosis and follow-up of AZOOR. Methods Retrospective analysis of clinical data of 52 cases (66 eyes) who were diagnosed through comprehensive eye examinations including best corrected visual acuity, fundus exam, OCT, electroretinogram (ERG), fluorescein angiography (FFA) and indocyanine green angiography (ICGA). Results A total of 52 cases of AZOOR (66 eyes) were collected. The majority of patients complained of blurred vision, photopsia and acute onset of a scotoma. In this group, 24 cases (28 eyes) with normal fundus were defined as AZOOR typeⅠ, while the other 28 cases (38 eyes) with fundus changes were AZOOR type Ⅱ, including 9 eyes of multiple evanescent white dot syndrome (MEWDS), 25 eyes of punctate inner choroidopathy (PIC),4 eyes of multifocal choroiditis (MC). All typeⅠcases went through visual field, ERG and OCT tests. The most common visual field defect was central and paracentral scotoma, which was seen in 15 eyes (53.6%). Nine eyes (32.1%) presented with blind spot enlargement or even associated with other visual field defects. Four eyes (14.3%) showed scattered scotoma. In the series of 24 typeⅠcases （28 eyes）, 12 eyes (42.9%) demonstrated depressed scotopic and photopic amplitudes, and nine eyes only yielded reduced scotopic amplitudes, while seven eyes showed normal. All OCT showed an absence of both the inner and outer segment (IS/OS) line, and (or) the cone outer segment tip (COST) line between the IS/OS line and RPE. Many grey-white or yellowish white punctuate lesion of different sizes were found in posterior pole of the fundus in all of type Ⅱ AZOOR which were more obvious in FFA. The manifestations of OCT showed IS/OS irregularity or absence in the area corresponding to the lesions. At final follow up from 15 days to two years, the IS/OS line became discernible in 13 of 24 typeⅠcases got discernible IS/OS line, while it was still absent in the other 11 case. During one to two month follow up period, nine eyes of MEWDS and four eyes of MC showed the presence of the a continuous IS/OS line in their OCT images after treatment, but there is no significant change for 25 eyes of PIC. ConclusionsOCT showed abnormalities in the microstructures of the outer retina, e.g., IS/OS line. The high resolution of OCT images has allowed better evaluations of the intraretinal IS/OS line in AZOOR, which presented a significant correlation with different stage in the course of AZOOR. In conclusions, OCT plays an important role in the diagnosis and follow up in AZOOR.
Objective To observe the characteristics of spectraldomain optical coherence tomography (SD-OCT) and fundus autofluorescence (FAF) in acute and chronic central serous chorioretinopathy (CSC).Methods Seven-three eyes of 67 patients with CSC diagnosed by slit-lamp microscopy, fundus photochromy, fundus fluorescein angiography (FFA) and indocyanine green angiography were enrolled in this study. All the patients were examined for FAF and SD-OCT. The patients were divided into acute CSC group (37 patients, 37 eyes) and chronic CSC group (30 patients,36 eyes) according to the clinical features and FFA images. According to the OCT feature in retinal detachment area, they were divided into three categories, which including intact, non-intact and atrophy outer segment, respectively. According to the FAF characteristics, they were divided into hyper-FAF, hypo-FAF and mixed type, respectively. The characteristics of SD-OCT and FAF of both acute and chronic CSC patients were evaluated and analyzed. Results In acute CSC group, 19 eyes (51.35%) were hypo-FAF, 18 eyes (48.65%) were hyper-FAF. In chronic CSC group, two eyes (5.56%) were hypo-FAF, 16 eyes (44.44%) were hyper-FAF, and 18 eyes (50.00%) were mixed type. There was significant difference between both groups (chi;2=31.872,P=0.000). The SD-OCT results showed that in acute group, 15 eyes (40.54%) were intact outer segment, 18 eyes (48.65%) were non-intact outer segment, and four eyes (10.81%) were atrophy outer segment. In chronic group, five eyes (13.89%) were intact outer segment, 17 eyes (47.22%) were non-intact outer segment, and 14 eyes (38.89%) were atrophy outer segment. There was significant difference between both groups (chi;2=10.572,P=0.005). Conclusions The FAF characteristics of acute and chronic CSC mainly manifests hypo-FAF and mixed type, respectively. The OCT characteristics of acute CSC mainly manifests intact outer segment and non-intact outer segment, but non-intact outer segment and atrophy outer segment in chronic CSC.