Near-Infrared Reflectance Imaging in Eyes with Acute Zonal Occult Outer Retinopathy

Purpose: To investigate the confocal scanning laser ophthalmoscopic images obtained with near-infrared (IR) light in eyes with acute zonal occult outer retinopathy (AZOOR). Methods: Observational case series. The medical records of 12 eyes of 10 patients with AZOOR were reviewed. Scanning laser ophthalmoscopic images obtained from the AZOOR eyes were compared with images obtained by spectral-domain optical coherence tomography, by fundus autofluorescence, and by an adaptive optics fundus camera. Results: In 8 of 12 eyes, abnormal hyporeflective areas were detected in the IR images, and the other 4 eyes did not have specific abnormalities in the IR images. The boundaries of the abnormal hyporeflective areas corresponded with the border of the irregularity of photoreceptor inner segment ellipsoid band in the spectral-domain optical coherence tomography images. The cone mosaics of the adaptive optics fundus image were disrupted in the abnormal hyporeflective area of the IR image. However, the areas of fundus autofluorescence abnormalities did not coincide with the hyporeflective areas in the IR images. Conclusion: The presence of hyporeflective areas in the IR images of patients with AZOOR suggests impairment of the photoreceptors area. The IR images would be useful to evaluate eyes with AZOOR.