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Jack Shao, Kimberly Baynes, Careen Y Lowder, Sunil K Srivastava; Characterization of Choroidal Thickness in Birdshot Chorioretinopathy with Active Retinal Vasculitis. Invest. Ophthalmol. Vis. Sci. 2014;55(13):239.
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The purpose of the study was to characterize choroidal thickness in patients with birdshot chorioretinopathy with retinal vasculitis before and after control of disease activity using spectral domain optical coherence tomography (SD-OCT).
A retrospective, consecutive, case series of all patients birdshot chorioretinopathy with retinal vasculitis in the last 4 years at the Cole Eye Institute, Cleveland Clinic was performed. Inclusion criteria: 1. Patients with Birdhshot Chorioretinopathy with retinal vasculitis and retinal vascular leakage seen at the Cole Eye Institute in the last 5 years 2. Treatment with retisert implants, immunomodulators, or prednisone 3. SD-OCT performed in the study eye with a fluorescein angiography prior and post-treatment 4. Improvement in control of disease activity based on fluorescein angiography We measured choroidal thickness at the fovea in active birdshot chorioretinopathy with diffuse retinal vascular leakage on fluorescein angiography. Pre-treatment choroidal thickness and post-treatment choroidal thickness were recorded.
16 eyes of 10 patients with birdshot chorioretinopathy were included in the study. 12 eyes were treated with retisert implants, 2 eyes were treated with a combination of cellcept and prednisone, and 2 eyes were treated with oral prednisone alone. All 16 eyes showed significant improvement of retinal vascular leakage by fluorescein angiography with treatment. 2 of 16 eyes had cystoids macular edema based on OCT. 13 of 16 eyes showed decreased choroidal thickness after treatment, 3 showed increased choroidal thickness. The average choroidal thickness prior to treatment was 280.9 um, and after treatment 234.6 um. Overall, there was a 15.8% decrease in choroidal thickness (p < 0.0042).
This is the first study that characterizes reduction of choroidal thickness in birdshot chorioretinopathy with active retinal vascular leakage after resolution of leakage on angiography. Changes in choroidal thickness may be more sensitive than cystoid macular edema in evaluating retinal vasculitis with leakage in birdshot chorioretinopathy and may be another way to monitor disease progression or response to treatment.
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