Acute zonal occult outer retinopathy in a patient with graft-versus-host disease

To investigate the mechanism of bilateral central vision loss in a patient with graft-versus-host disease. Observational case report. A 43-year-old man with graft-versus-host disease developed acute painless progressive central vision loss, first in the left eye and then in the right. The patient un...

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Bibliographic Details
Published in:American journal of ophthalmology 2004-12, Vol.138 (6), p.1058-1060
Main Authors: Cheung, Marsha C., Nune, George C., Hwang, David G., Sutter, Erich E., Duncan, Jacque L.
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Autoimmune diseases
Biological and medical sciences
Bone marrow
Disease
Electroretinography
Eyes & eyesight
Fluorescein Angiography
Graft vs Host Disease - complications
Graft vs Host Disease - diagnosis
Humans
Male
Medical sciences
Ophthalmology
Ophthalmoscopy
Retinal Diseases - diagnosis
Retinal Diseases - etiology
Retinopathies
Transplants & implants
Vision Disorders - diagnosis
Vision Disorders - etiology
Visual Acuity
Visual Field Tests
Visual Fields
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Summary:To investigate the mechanism of bilateral central vision loss in a patient with graft-versus-host disease. Observational case report. A 43-year-old man with graft-versus-host disease developed acute painless progressive central vision loss, first in the left eye and then in the right. The patient underwent slit-lamp biomicroscopy, indirect ophthalmoscopy, fluorescein angiography, visual field testing, full-field electroretinography, multifocal electroretinography, and testing for paraneoplastic antibodies. Fundus examination and fluorescein angiography were unremarkable. Goldmann perimetry revealed enlarged blind spots with central scotomas bilaterally. An electroretinogram testing showed asymmetric retinal dysfunction, consistent with acute zonal occult outer retinopathy. No paraneoplastic autoantibodies were detected. The patient continued to have asymmetric progressive vision loss that stabilized over the next 6 months. Graft-versus-host disease should be included in the autoimmune conditions associated with AZOOR.
ISSN:0002-9394
1879-1891
DOI:10.1016/j.ajo.2004.06.042