Purpose: To report a case in which microperimetry (MP-3, Nidek, Aichi, Japan) was useful to determine the disease state of acute zonal occult outer retinopathy (AZOOR) during steroid treatment
Case presentation: A 20-year-old woman presented at our hospital with the chief complaints of acutely decreased visual acuity and photopsia in the left eye. Corrected visual acuity in her left eye had decreased to 0.06 and Goldmann perimetry (GP) revealed central scotoma. Based on this and other findings including diffuse ellipsoid zone impairment revealed by optical coherence tomography (OCT) and weak waves in multifocal electroretinograms, the patient was diagnosed with AZOOR. After performing one course of steroid pulse therapy, GP indicated enlarged central scotoma, but the patient stated that her subjective symptoms improved. MP-3 resulted in an improvement in retinal sensitivity. Based on the degree of subsequent improvement in retinal sensitivity, pulse therapy appeared to be more effective than oral steroid therapy. Therefore, the patient received a total of three courses of steroid pulse therapy. At 3 months after the initial examination, her visual acuity improved to 1.2 and the central scotoma disappeared.
Conclusions: MP-3 can be used for detailed visual field assessment even in patients with vision fixation problems, such as central scotoma. Moreover, MP-3 measured over time is also useful in evaluating the state of AZOOR and determining the treatment strategy.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 122: 772-778, 2018.