Supplementary Material for: Usefulness of color laser scanning ophthalmoscopy and optical coherence tomography angiography in the diagnosis of acute zonal occult outer retinopathy complex: a report of two cases

Introduction: The term “acute zonal occult outer retinopathy (AZOOR) complex" encompasses a group of conditions associated with photoreceptor damage, and most patients with AZOOR complex experience irreversible visual-field defects and retinal pigment epithelium atrophy with no effective treatment. Herein, we report two cases of AZOOR complex in which multimodal imaging, including color scanning laser ophthalmoscopy (SLO) and en face optical coherence tomography (OCT) angiography (OCTA), facilitated diagnosis and monitoring.
Case Presentation: Case 1 involved a 23-year-old woman who presented with visual-field disturbances in the left eye. The OCT B-scan revealed ellipsoid zone (EZ) irregularities, and color SLO and en face OCTA of the EZ slab showed corresponding hyporeflective areas in the green channel and hypointense regions, respectively. Case 2 involved a 38-year-old woman with decreased visual acuity in the left eye. Imaging findings were similar to those in Case 1, and color SLO and en face OCTA revealed abnormalities corresponding to the EZ disruption. In both cases, follow-up imaging revealed improvement in EZ integrity and corresponding changes in color SLO and OCTA findings.
Conclusion: Multimodal imaging using color SLO and en face OCTA provide valuable information regarding the extent and progression of photoreceptor damage in AZOOR complex, which supplement the conventional OCT B-scan findings. These modalities may enhance the diagnostic accuracy and monitoring of patients with AZOOR complex.