June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017

The effect of early systemic treatment on the decrease of choroidal thickness in birdshot retinochoroiditis.
Author Affiliations & Notes
  • Natalia Andreevna Skvortsova
    Posterior Eye Segment Diagnostics and Surgery Center, Moscow, Russian Federation
  • Bruno Jeannin
    Retinal and Inflammatory Diseases, Centre for Ophthalmic Care, Lausanne, Switzerland
  • Amel Gasc
    Retinal and Inflammatory Diseases, Centre for Ophthalmic Care, Lausanne, Switzerland
  • Carl P. Herbort
    Retinal and Inflammatory Diseases, Centre for Ophthalmic Care, Lausanne, Switzerland
  • Footnotes
    Commercial Relationships   Natalia Skvortsova, None; Bruno Jeannin , None; Amel Gasc, None; Carl Herbort, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 501. doi:
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      Natalia Andreevna Skvortsova, Bruno Jeannin, Amel Gasc, Carl P. Herbort;
      The effect of early systemic treatment on the decrease of choroidal thickness in birdshot retinochoroiditis.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):501.

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

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Abstract

Purpose : Birdshot retinochoroiditis (BRC) is a rare autoimmune disease affecting the retina and choroid independently. Choroidal inflammation responses to systemic treatment rapidly. This retrospective study tested the hypothesis that early and sustained systemic treatment preserves choroidal thickness (ChT) in BRC.

Methods :
Patients with a disease duration ≥10 years were divided into two groups depending on their treatment status: early and sustained therapy (treated patients) versus insufficient, late, or no treatment (undertreated patients) and enhanced depth imaging optical coherence tomography (EDI-OCT) measurements of ChT were analyzed retrospectively. The exclusion criteria were high myopia or hyperopia (more than 6 diopters), substantial media opacities affecting visual acuity (i.e. cataract) and the quality of OCT-scans, and a history of other retinal or choroidal diseases. The OCT images were evaluated and ChT was calculated horizontally and vertically in the macula, the calculation was performed in blind manner by two independent observers. ChT was compared in treated and undertreated groups along with the number of typical fundus BRC lesions.

Results :
13 patients (24 eyes) with BRC (5M/8F) were included in the study. The mean age at the moment of ChT measurement was 61.4 ± 11.2 years. Mean disease duration was 13.7 ± 3.7 years. The HLA-A29 antigen was positive in all patients. There were no significant differences in age, sex, disease duration, and refractive error between the two groups. A significant difference in ChT was observed between adequately treated (13 eyes) and undertreated patients (11 eyes) (288.3 ± 76.9 µm vs 161.4 ± 39.2 µm; P≤0.0001, Mann-Whitney U test). In the group with insufficient therapy, 10 of 11 eyes presented typical fundus BRC lesions while only 2 of 13 eyes presented the same typical BRC lesions in the treated group (P≤0.0006, two-tailed F-test).

Conclusions :
Choroidal thickness decreases significantly less during long term follow-up if patients are treated early and adequately when compared to undertreated patients. In parallel BRC fundus lesions are significantly more numerous in the latter group.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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