Correlation between decreased choroidal blood flow velocity and the pathogenesis of acute zonal occult outer retinopathy

Clin Exp Ophthalmol. 2014 Mar;42(2):139-50. doi: 10.1111/ceo.12143. Epub 2013 Jul 11.

Abstract

Background: To evaluate changes of choroidal circulation quantitatively using laser speckle flowgraphy in patients with acute zonal occult outer retinopathy.

Design: Retrospective observational case series.

Participants: Sixteen eyes of 11 acute zonal occult outer retinopathy patients: seven non-treated eyes with good visual acuity and nine systemic corticosteroid-treated eyes with progressive visual acuity loss. Six eyes with thyroid-associated ophthalmopathy receiving systemic corticosteroid therapy served as controls.

Methods: The mean blur rate, an index of quantitative relative blood flow velocity, in the affected area was measured by laser speckle flowgraphy. The changes of mean blur rate, best-corrected visual acuity and the average threshold at the affected area on Humphrey perimetry during 24-week follow up were analysed.

Main outcome measures: Mean blur rate, best-corrected visual acuity, and the average threshold.

Results: In non-treated eyes, the average mean blur rate significantly increased at 24 weeks, with a significant increase of the average threshold. In corticosteroid-treated eyes, the mean blur rates at 1, 4, 12 and 24 weeks were significantly higher than the pretreatment value, with significant improvement of best-corrected visual acuity and the average threshold. The increase in mean blur rate at 4 weeks in corticosteroid-treated acute zonal occult outer retinopathy eyes was significantly higher than that in corticosteroid-treated control eyes.

Conclusions: In eyes with acute zonal occult outer retinopathy, the mean blur rate at the affected area significantly increases along with improvement of visual functions. These results suggest that impaired choroidal circulation is involved in the pathogenesis of acute zonal occult outer retinopathy.

Keywords: acute zonal occult outer retinopathy; choroidal circulation; laser speckle flowgraphy; systemic corticosteroid therapy.

MeSH terms

  • Adult
  • Blood Circulation / physiology*
  • Blood Flow Velocity
  • Choroid / blood supply*
  • Female
  • Fluorescein Angiography
  • Glucocorticoids / therapeutic use
  • Humans
  • Laser-Doppler Flowmetry
  • Male
  • Middle Aged
  • Retrospective Studies
  • Scotoma / drug therapy
  • Scotoma / etiology*
  • Scotoma / physiopathology*
  • Visual Acuity / physiology
  • Visual Field Tests
  • Visual Fields
  • White Dot Syndromes
  • Young Adult

Substances

  • Glucocorticoids

Supplementary concepts

  • Acute zonal occult outer retinopathy