Acute zonal occult outer retinopathy (AZOOR) associated with multifocal choroidopathy

Holz, Frank G.; Kim, R Y; Schwartz, S D; Harper, C Alex; Wroblewski, John J.; Arden, G. B.; Bird, Alan C.

doi:10.1038/eye.1994.15

Cited by 66 publications

(38 citation statements)

References 19 publications

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“…Moreover, similarities between AZOOR, multiple evanescent white dot syndrome, multifocal choroiditis, punctate inner choroidopathy, acute macular retinopathy, and acute idiopathic blind spot enlargement have been described previously (4,5,20,37,40). Some of these conditions have been associated with histoplasmosis (8,14). In line with these observations, we reported that AZOOR may be caused by a fungal infection (6).…”

supporting

confidence: 73%

“…Evidence of strong fluorescence in fluorescein angiograms, typical of some of these patients, may reveal transient uptake of this dye by the fungus. In addition, similarities between AZOOR and histoplasmosis, a disease caused by the fungus Histoplasma capsulatum, with respect to the results of funduscopic examinations have been described previously (14,17). Unambiguous confirmation that yeast infection causes AZOOR or SC will come from clinical trials that aim to investigate the beneficial effects of antifungal treatments.…”

Section: Discussionmentioning

confidence: 99%

“…Typical characteristics of this disease include (i) acute loss of retinal peripheral vision in one or both eyes, (ii) normal funduscopic examination results in the early stages of the disease, and (iii) extensive abnormalities in retinograms whereas evoked potentials are normal (14,17,23,36). A mixed dysfunction of rods and cones is observed, although cones are usually more affected.…”

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confidence: 98%

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Fungal Infection in Patients with Serpiginous Choroiditis or Acute Zonal Occult Outer Retinopathy

et al. 2008

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The etiologies of a number of retinopathies, including serpiginous choroiditis and acute zonal occult outer retinopathy (AZOOR), remain uncertain. Recently, we provided evidence that AZOOR is caused by Candida famata infection. The purpose of this article was to investigate the presence of fungal infection in five patients affected with serpiginous choroiditis and five patients with diagnosis of AZOOR. To assess the presence of fungal infection the presence of antibodies in human serum samples against C. famata, C. albicans, C. parapsilosis, C. glabrata and C. krusei was analyzed. In addition, quantitative PCR was carried out to detect fungal genomes in whole blood. Finally, the presence of fungal antigens in the serum samples of patients was investigated. Three AZOOR patients presented high antibody titers against Candida spp., while antibodies against Candida spp. were observed in serum samples from four patients with serpiginous choroiditis. Fungal genomes in peripheral blood were evidenced in serum samples from one AZOOR and four serpiginous choroiditis patients. Fungal antigens were also apparent in the serum of different patients. Our findings indicate that there was evidence of disseminated fungal infection in most patients examined.

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confidence: 73%

Section: Discussionmentioning

confidence: 99%

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confidence: 98%

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Fungal Infection in Patients with Serpiginous Choroiditis or Acute Zonal Occult Outer Retinopathy

et al. 2008

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“…This idea is consistent with the available evidence that we have about the characteristics of AZOOR. Indeed, some clinical similarities with histoplasmosis syndrome, another fungal infection, were noted in the retina (9,17). The evolution of AZOOR over the course of years with several recurrences, depending on the patient (14), is consistent with the progress of some fungal infections, since fungi usually grow slowly compared to the rates of growth of some bacteria and viruses, and the infections are recurrent.…”

Section: Discussionmentioning

confidence: 76%

“…No clear positive effects of corticosteroid treatment were found in some patients (17), particularly those on a long-term treatment regimen. This agrees well with the notion of the infective nature of this disease.…”

Section: Discussionmentioning

confidence: 94%

Isolation ofCandida famatafrom a Patient with Acute Zonal Occult Outer Retinopathy

et al. 2005

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The etiology of a number of retinopathies, such as acute zonal occult outer retinopathy (AZOOR), remains undetermined. Candida famata was isolated from conjunctival exudates of a patient diagnosed with AZOOR. This yeast was very abundant, particularly in the more affected eye, while no other pathogens or fungal species were in evidence. Immunological tests revealed the presence of antigen-specific T lymphocytes by using C. famata as a challenge. Moreover, enzyme-linked immunosorbent assay analysis showed the presence of specific antibodies against this yeast in the patient's blood. Delayed hypersensitivity by use of a skin test was also positive. Finally, antifungal treatments led to improvements in several clinical symptoms, including funduscopic analysis. However, despite prolonged treatment with fluconazole and itraconazole, C. famata still appeared in the conjunctival exudates. The new antifungal voriconazole may represent a better choice for treatment.

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Acute Zonal Occult Outer Retinopathy in Patients With Multiple Evanescent White Dot Syndrome

Fine

Spaide²,

Ryan³

et al. 2009

Arch Ophthalmol

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To describe cases of acute zonal occult outer retinopathy (AZOOR) in patients previously diagnosed as having multiple evanescent white dot syndrome (MEWDS). Methods: In a retrospective case series, we studied fundus photographs, fundus autofluorescence images, optical coherence tomographic scans, fluorescein and indocyanine green angiograms, visual fields, and results of electroretinography. Results: Three patients diagnosed as having MEWDS developed clinical, angiographic, autofluorescence, visual field, and/or electrophysiologic evidence of AZOOR. Spectral domain optical coherence tomographic findings dis-REPORT OF CASES CASE 1 A healthy 29-year-old white woman sought care for blurry vision in the right eye and periorbital pain. Results of review of systems were negative, although the patient noted having had a purified protein derivative antigen skin test 2 days earlier. Vi

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Acute zonal occult outer retinopathy (AZOOR) associated with multifocal choroidopathy

Cited by 66 publications

References 19 publications

Fungal Infection in Patients with Serpiginous Choroiditis or Acute Zonal Occult Outer Retinopathy

Fungal Infection in Patients with Serpiginous Choroiditis or Acute Zonal Occult Outer Retinopathy

Isolation ofCandida famatafrom a Patient with Acute Zonal Occult Outer Retinopathy

Acute Zonal Occult Outer Retinopathy in Patients With Multiple Evanescent White Dot Syndrome

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