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A 35 year old woman presents with an episode 9 months ago of acute peripheral field loss with associated flashing lights. A visual field test at the time showed an enlarged blind spot.
On exam today, she has 20/20 vision but a right RAPD and the fundus appearance and visual field shown below.
The most likely diagnosis is...
What is AZOOR (acute zonal occult outer retinopathy)?
Note the clumping of RPE with corresponding VF defect, history of photopsias, and poor recovery of vision over time (in contrast with MEWDS which usually resolves).
60% of AZOOR is initially unilateral, but 60% (of unilaterals) become bilateral eventually. Fluorescein angiography demonstrates window defect.