A Systematic Review of Acute Zonal Occult Outer Retinopathy with a Focus on Attempted Treatment Modalities

Abstract

Acute zonal occult outer retinopathy (AZOOR) is a presumed inflammatory disorder leading to sectoral outer retinal dysfunction. This condition is characterized by unilateral acute or subacute onset of photopsias and visual field defects with an often relatively unremarkable funduscopic exam. There is frequently gradual progression of symptoms with involvement of the fellow eye, although final visual acuity usually remains preserved. This comprehensive literature review of currently published cases seeks to review the natural history, prognosis, diagnostic modalities, and treatments used for patients with AZOOR. Patients with AZOOR are most commonly either observed for progression or treated with steroid therapy or other non-steroidal immunomodulatory agents. Less commonly, antivirals, antifungals, and other therapies have also been used with variable success. Overall, evidence supporting specific treatments for AZOOR remains difficult to interpret given the favorable natural history of the disease as well as a paucity of prospective trials and complete lack of randomized controlled trials.