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• Vol.47 No.2/3
• CLINICA NEUROL, 47: 116−118, 2007
• Vol.47 No.2/3 contents

Brief Clinical Note

A case of acute zonal occult outer retinopathy (AZOOR): a 15 years' mislabeling as retrobulbar optic neuritis

Akihiro Shindo, M.D.¹⁾, Yasumasa Kokubo, M.D.¹⁾, Akira Taniguchi, M.D.¹⁾, Manami Kuze, M.D.²⁾ and Shigeki Kuzuhara, M.D.¹⁾

¹⁾Department of Neurology, Mie University Graduate School of Medicine
²⁾Department of Ophthalmology, Mie University Graduate School of Medicine

A 30-year-old woman was admitted to Mie University Hospital for recurrence of sudden visual field defect with photopsia in the right eye. She had experienced the same episodes at the age of 15, 20, 25 and 28 years old. A diagnosis of retrobulbar optic neuritis had been made at each episode, but corticosteroid therapy failed to resolve the symptoms. Neurologic examination on admission was unremarkable except for the visual field defect of the right eye. Brain MRIs with and without gadolinium enhancement were normal. On ophthalmologic examination, visual acuity was normal, but the Mariotte blind spot of the right eye was expanded. Ophthalmoscopic examination, visual evoked potential, flicker electro-oculogram and Hess test were normal. Multifocal electroretinogram (ERG) revealed reduction in the inferior temporal response of the right eye that corresponded to the expansion of the Mariotte blind spot. These findings were consistent with conditions of acute zonal occult outer retinopathy (AZOOR). The visual symptoms of AZOOR thus resemble those of retrobulbar optic neuritis and findings of multifocal ERG were useful to differentiate them. AZOOR is a newly established condition, and it is necessary to pay more attention to AZOOR on the differential diagnoses of acute-onset mono ocular visual disturbances.

(CLINICA NEUROL, 47: 116−118, 2007)
key words: retrobulbar optic neuritis, acute zonal occult outer retinopathy (AZOOR), multiple sclerosis

(Received: 23-Aug-06)