Recovery of outer retina in acute idiopathic blind spot enlargement (AIBSE)

Purpose: To report the anatomic and functional recovery of the ellipsoid zone in a case of acute idiopathic blind spot enlargement (AIBSE), which was documented by serial high-resolution optical coherence tomography imaging. Observations: The patient's clinical presentation and follow up visits were documented via Humphrey's Visual Fields, fundus autofluorescence, and high resolution spectral domain optical coherence tomography (SD-OCT). At presentation, Humphrey's Visual Field testing showed an enlarged blind spot in the right eye. Fundus autofluorescence and optical coherence tomography showed an increased peripapillary autofluorescence and loss of the outer retinal layers, respectively. At 3 months a modest improvement in the visual field was observed. This improvement was stable at both the 7 and the 15 month follow up visits. SD-OCT corresponding to the areas of visual field improvement demonstrated recovery of the outer retina. Conclusion and importance: Serial OCT imaging demonstrated anatomic evidence of ellipsoid zone recovery in isolated AIBSE. Anatomic recovery was consistent with the functional gain detected by visual field improvement