September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Baseline prognostic factors in patients with Birdshot retinochoriopathy( BRC) .
Author Affiliations & Notes
  • Chrysoula Koutsiouki
    Medical Retina , Moorfields Eye Hospital , London, england, United Kingdom
  • Anthony G Robson
    Medical Retina , Moorfields Eye Hospital , London, england, United Kingdom
    Electrodiagnostic , UCL Institute of Ophthalmology , London, England, United Kingdom
  • Graham E Holder
    Medical Retina , Moorfields Eye Hospital , London, england, United Kingdom
    Electrodiagnostic , UCL Institute of Ophthalmology , London, England, United Kingdom
  • Angela Rees
    Medical Retina , Moorfields Eye Hospital , London, england, United Kingdom
  • Carlos Pavesio
    Medical Retina , Moorfields Eye Hospital , London, england, United Kingdom
  • Mark C Westcott
    Medical Retina , Moorfields Eye Hospital , London, england, United Kingdom
    Medical Retina , Institute of ophthalmology , London , United Kingdom
  • Footnotes
    Commercial Relationships   Chrysoula Koutsiouki, None; Anthony Robson, Foundation Fighting Blindness (F), NIHR Moorfields Biomedical Research Centre (F); Graham Holder, Foundation Fighting Blindness (F), NIHR Moorfields Biomedical Research Centre (F); Angela Rees, None; Carlos Pavesio, None; Mark Westcott, None
  • Footnotes
    Support  Grant Fight for sight award
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 4122. doi:
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      Chrysoula Koutsiouki, Anthony G Robson, Graham E Holder, Angela Rees, Carlos Pavesio, Mark C Westcott; Baseline prognostic factors in patients with Birdshot retinochoriopathy( BRC) .. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4122.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To identify baseline demographic, clinical and functional prognostic factors in patients with BRC.

Methods : Retrospective chart review of 52 consecutive BCR patients (35 females,17 males), attending a tertiary referral centre (Moorfields Eye Hospital, London, UK), with a minimum of 3 years follow-up. For each patient, the functional status at final visit was determined according to 3 criteria: visual acuity, Humphrey SITA standard (HVF MD) and International standard electrophysiology (PERG P50, DA 10.0 a-wave, DA 10.0 b-wave and LA 3.0 30Hz flicker ERG amplitudes and 30Hz flicker ERG timing). Each parameter was categorized as normal, mildly or severely impaired according to previously accepted criteria. Each parameter was separately correlated with baseline prognostic features, including patient demographics, baseline functional status, and clinical features (OCT and fluorescein angiography).Analysis was performed using contingency tables (Exact analysis for sparsely populated tables), setting p < 0.01 to account for multiple tests.

Results : Mean age at presentation was 53 years (range 34-86), with mean follow up 7.7 years (range 3 – 21). More than 80% of patients retained normal, or only mildly abnormal, visual function at the final visit, according the above parameters.
Baseline factors most significantly associated (positively) with good versus poor final visit functional outcome were baseline HFA MD, DA 10.0 b- wave amplitude, the absence of retinal atrophy, LA 3.0 30Hz flicker and DA 10.0 a-wave amplitudes (all at p< 0.001). Factors weakly and inconsistently predictive were LA 3.0 30Hz ERG timing and PERG P50 amplitude (all at p<0.01). Age at presentation, baseline visual acuity, and the presence or absence of macular edema had no prognostic value. The duration of follow-up (subdivided according to tertile) did adversely affect final status for DA 10.0 ERG b-wave and LA 3.0 30Hz flicker ERG amplitudes (p< 0.01), but not for the other electrophysiological parameters, nor HFA MD or acuity.

Conclusions : The majority of patients received aggressive treatment and attained normal or near normal visual function. Baseline characteristics, including HVF, and some electrophysiological parameters were predictive, as was the presence of retinal atrophy. Baseline macular edema was not predictive. Longstanding disease (longer than 8.3 years) may be associated with reduction of some electrophysiological parameters

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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