Purchase this article with an account.
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.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
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.
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.
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).
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.
This PDF is available to Subscribers Only