History of Present Illness
A 70-year-old woman was referred 4 years prior for scotomas left eye (OS) with associated photopsias and difficulty on light–dark transition. Electroretinography (ERG) at that time was markedly reduced OS, and a presumptive diagnosis of acute zonal occult outer retinopathy (AZOOR) OS was made. After significant discussion with the patient that minimal data on efficacy of treatment were available, she opted for a short course of oral corticosteroids, resulting in subjective improvement in symptoms and objective improvement on visual fields. The patient was then transitioned to mycophenolate mofetil 1000 mg by mouth (PO) twice a day (BID). She was stable on this regimen until 2 weeks prior to presentation, when she noted decreasing vision right eye (OD) with associated malaise and fever .
| OD | OS | |
|---|---|---|
| Visual acuity | 20/20− | 20/40− |
| Intraocular pressure (IOP) | 15 | 20 |
| Sclera/conjunctiva | White and quiet | White and quiet |
| Cornea | Clear | Clear |
| Anterior chamber (AC) | Deep and quiet | Deep and quiet |
| Iris | Unremarkable | Unremarkable |
| Lens | Clear | Posterior chamber intraocular lens (PCIOL) with 1+ posterior capsular opacification (PCO) |
| Anterior vitreous | Debris | Debris |
| DFE | See Fig. 81.1 | unremarkable |
