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R Neumann, S Krupsky; Early Diagnosis of Birdshot Choriditis . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4261.
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Purpose: The potential role of workup using ICG angiography in eyes with posterior inflammation was assessed. This work evaluates early diagnosis of Birdshot Choroiditis (BSC). BSC may present as bilateral vitreitis while the appearance of the pathognomonic multiple cream colored lesions be delayed for years. Methods: Patients with posterior uveitis answered a medical questionnaire regarding past medical history and underwent complete ocular examination and routine uveitis laboratory workup. Flourescein and ICG angiographies were routinely administered for posterior uveitis with questionable diagnosis. Results: Three patients, two males and one female, ages 30-38 presented with posterior uveitis without clinical or fluorescein angiography (FA) criteria of any specific entity. Retinal lesions typical to BSC were not observed. Medical questionnaire and routine uveitis laboratory workup were not diagnostic. ICGA revealed hypofluorescent oval lesions in the posterior pole that paralleled choroidal veins, a pattern typical to BSC. Accordingly, HLA-A29 was obtained and found positive in all three cases substantiating the diagnosis. Conclusions: Routine ICG angiography in posterior segment inflammation may identify signs of BSC at a stage where clinical pathognomonic signs have not yet developed. Early diagnosis may enable frequent follow-up and subsequent anti-inflammatory therapy adjusted to the level of inflammation. Early proper management may prevent the grave late developments of the disease.
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