Acute Annular Outer Retinopathy: Literature Review and a Report of 2 Cases

Acute annular outer retinopathy (AAOR) is an uncommon disease. We present 2 illustrative cases and demonstrate disease evolution using multimodal imaging. The 18 previously reported cases in the peer-reviewed English literature are also reviewed. We conducted a case series and literature review. We observed complete structural resolution by spectral-domain optical coherence tomography (SD-OCT) and ultra-widefield fundus autofluorescence in 1 case. In the literature review, 20 cases of AAOR were identified, including the 2 we have presented. Fifteen cases were unilateral and 5 bilateral, resulting in a total of 25 eyes with AAOR. Presenting symptoms included visual field defects (72%), decreased vision (48%), and photopsia (36%). Sixty-eight percent had a final visual acuity better than or equal to 20/40, while a minority (14%) were 20/200 or worse. Clinically, all eyes had a peripapillary annular band of gray-white opacification of the deep retina. We have reviewed and summarized the 18 previously reported cases of AAOR in the English literature and have shown for the first time that AAOR may undergo complete recovery of the external limiting membrane and ellipsoid zone on SD-OCT with resolution of disease. There is still much to be understood regarding the pathogenesis of and optimal management of AAOR