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L Cimino, TV Tran, CP Herbort; Sensitivity of Visual Field Testing in the Appraisal and Follow-up of Birdshot Chorioretinopathy . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4260.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: We have previously indicated (Arch. Ophthalmol 1998;116:1389-91) that visual field testing in birdshot chorioretinopathy seems a very sensitive functional test to monitor disease activity. The purpose in this study was to correlate visual field findings with visual acuity, inflammatory parameters and angiographic features and determine its use in reflecting disease activity. Methods: Birdshot patients seen at La Source Eye Center in Lausanne and at the Department of Ophthalmology of Parma University Hospital had their visual field analysed by computerized campimetry and correlated to disease activity in a partially prospective fashion. Visual field defect was assessed at entry and its evolution was monitored at each major follow-up visit and correlated to treatment level by analyzing clinical parameters of inflammation, laser flare photometry as well as fluorescein & ICG angiographic signs. Results: Thirteen patients (9 females, 3 males, aged 33 to 68 at entry, mean age = 55.8 ± 19)) with birdshot chorioretinopathy were seen in the two centers from 1995 to 2001. Computerized visual field was available in all patients and a prospective long term follow-up (mean 30±18 months) was available in nine patients. The main results were the following: visual field was abnormal in all 13 patients with a mean MD of 8.96 +/- 5.8 of whom 9 had a full visual acuity. Visual field was well corelated with other parameters reflecting inflammatory activity such as vitreous infiltration as well as ICG (dark dots) & fluorescein angiographic (papillitis and vasculitis). It was a more sensitive functional parameter than visual acuity being the only routine functional parameter allowing monitoring of disease activity in patients with full vision. In 3 patients with full vision only the visual field showed progression of disease indicating unsufficient therapy and in another 2 patients stability of the visual field defect allowed observation without therapy. Conclusion: Our data show that the visual field is pathological in all cases of birdshot chorioretinopathy even though visual acuity is full. We showed it to be an extremely sensitive and easily performed procedure to monitor disease activity and to assess impact of therapy. It should be part of the regular follow-up procedures in this inflammatory condition. Together with newer methods such as ICG angiography it will certainly contribute to a more precise management of this condition.
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