Purpose: To review the clinical features of acute zonal occult outer retinopathy (AZOOR) in Chinese patients. Methods: All patients with AZOOR during 2002–2004 in our hospitals were reviewed retrospectively. Results: Seven consecutive Chinese patients with AZOOR were recruited and followed up for 4–18 months. Their age ranged from 26 to 47 years and all were affected bilaterally. They were from the cities near the Pacific Ocean and were used to eating seafood. The common complaints were slightly reduced visual acuity and photopsia. At least one eye of each patient had a visual field defect or decreased local area sensitivity and one patient had bilateral blind spot enlargement. Ten in 14 eyes showed increased numbers of vitreous cells and 4 eyes had anterior chamber inflammatory cells and a keratic precipitate. In their initial examination, minimal or no fundus changes were found, only yellow-white dots or gray dots presented on the deep retina or outer retinal layer. Fundus fluorescent angiography showed large-area depigmentation and hyperfluorescein spots corresponding to fundus findings. Electroretinogram (ERG) or multifocal ERG was abnormal in all eyes with no changes in their follow-up examination. Not all of the initial diagnoses of these patients were consistent with the final ones. Conclusions: AZOOR is not a common disease in China, but easy to misdiagnose. Female predilection, photopsia, visual field defect, ERG abnormality and minimal ophthalmoscopic changes are the common characteristics of AZOOR in Chinese patients. Living habits may play a role in the development of AZOOR.
A 36-year-old man with a history of consanguineous marriage between his parents presented with bilateral membranous cataract that was complicated by bilateral rhegmatogenous retinal detachment (RRD). Biomicroscopy revealed an absence of the crystalline lens bilaterally, a single piece of integrated fibrotic membrane in the right eye, and a membrane with a central cleft at the level of the ciliary process in the left eye. A small amount of residual cortex was revealed in the peripheral part of the membranes bilaterally when the pupils were dilated. Funduscopic examination showed that the vitreous liquefied and retina detached bilaterally. The successful retinal reattachment by vitrectomy and the finding of a retinal tear proved that the RD was rhegmatogenous. This case investigates bilateral membranous cataract with bilateral RRD as a new syndrome, or whether RRD may be a new complication of membrane cataract.
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