To evaluate the disease involvement in a patient with acute zonal occult outer retinopathy (AZOOR). Observational case report. A patient with acute zonal occu lt outer retinopathy was imaged with fundus photography, fluorescein and indocya nine green angiography, and autofluorescence photography. There was subtle depig mentation in the central portion of the lesion with a drusen like deposit at th e outer border. Fluorescein angiography showed a transmission defect centrally a nd a blocking defect at the border where the drusenoid material accumulated. Aut ofluorescent photography demonstrated that the drusenoid material was intensely autofluorescent, consistent with the presence of lipofuscin, and the central por tion of the lesion showed atrophy of the retinal pigment epithelium. Indocyanine green angiography showed atrophy of the choriocapillaris underlying areas of at rophy of the retinal pigment epithelium. In this case acute zonal occult outer r etinopathy caused an area of retinal pigment epithelium cell death with lipofusc in laden cells at the border of the expanding lesion and associated atrophy of the underlying choriocapillaris.
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