Acute annular outer retinopathy : Report of four cases

Abstract PURPOSE: To describe the clinical findings and course in four patients with acute annular outer retinopathy. METHODS: Four patients were evaluated during the course of acute annular outer retinopathy, and the historical and clinical findings were retrospectively collected. RESULTS: Four healthy patients developed the acute onset of visual field loss associated with a localized, white annular outer retinopathy. All patients were caucasian; two were women, aged 29 and 32 years, and two were men, aged 71 and 79 years. The mean follow-up was 3.9 years (range, 1 to 6 years). On presentation, four eyes had an irregular, incomplete, peripapillary, annular band of gray-white, deep retinal opacification with visual acuities that varied from 20/25 without foveal involvement to counting fingers with foveal involvement. Laboratory serologies were unremarkable. Two patients did not receive any treatment, and two received varying courses of oral corticosteroids with subjective improvement. Of the four eyes, two eyes developed ophthalmoscopic sequelae, one eye did not, and one had evidence of retinal pigment epithelial damage and narrowing of the retinal vessels on presentation. CONCLUSIONS: These four cases of acute annular outer retinopathy expand our knowledge of this disorder. Acute annular outer retinopathy may be a distinct entity or it may represent a variant of acute zonal occult outer retinopathy. As more cases are recognized, the characteristic features of the disease spectrum, the etiology, and treatment options may be better elucidated.