Image of the Month - August 2020

The image series demonstrates a patient with acute zonal outer occult retinopathy (AZOOR) with overlapping features of multiple evanescant white dot syndrome (MEWDS) in the left eye. The patient was a young, healthy man with acute vision changes without viral prodrome. The fundus photo shows multiple small yellow-white dots (top left) which are hyperautofluorescent on FAF (bottom left). The FA demonstrated RPE window defects with wreath-like staining (top right). The OCT was consistent with significant disruption of the outer retina and subretinal fluid (bottom right). There were few posterior vitreous cells. Following a negative infectious workup, oral steroids were commenced which led to improvement of visual acuity and fundus features.