移植物抗宿主病发生急性隐匿性带状外层视网膜病变

Acute zonal occult outer retinopathy in a patient with graft-versus-host disease

To investigate the mechanism of bilateral central vision loss in a patient wit h graft-versus-host disease. Observational case report. A 43-year-old man wi th graft-versus-host disease developed acute painless progressive central visi on loss, first in the left eye and then in the right. The patient underwent slit -lamp biomicroscopy, indirect ophthalmoscopy, fluorescein angiography, visual f ield testing, full-field electroretinography, multifocal electroretinography, a nd testing for paraneoplastic antibodies. Fundus examination and fluorescein ang iography were unremarkable. Goldmann perimetry revealed enlarged blind spots wit h central scotomas bilaterally. An electroretinogram testing showed asymmetric r etinal dysfunction, consistent with acute zonal occult outer retinopathy. No par aneoplastic autoantibodies were detected. The patient continued to have asymmetr ic progressive vision loss that stabilized over the next 6 months. Graft-versus -host disease should be included in the autoimmune conditions associated with A ZOOR.