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Sukhum Silpa-archa, Joan Jean Lee, Sutasinee Boonsopon, Pranav Patel, Charles Stephen Foster; Risk Factors for Poor Visual Outcome in Birdshot Retinochoroidopathy Patients. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1721.
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Though recognized as chronic disease with poor visual prognosis, no study identifies risk factors of poor visual outcome in birdshot retinochoroidopathy (BSRC) patients. We conducted a retrospective, comparative clinical study to explore the associated risk factors to predict poor visual outcome in BSRC patients.
We performed chart review of BSRC patients who were evaluated at Massachusetts Eye Research & Surgery Institution (MERSI) from 2005 to 2014 with a follow-up period at least 12 months. Ninety-eight patients (196 eyes) were identified. They were categorized into 2 groups; poor vision and good vision. The definition of poor visual outcome was defined as less than -6 mean deviation on Swedish interactive threshold algorithm (SITA) short-wavelength automated perimetry (SWAP) and abnormality (amplitude or implicit time) in 30 Hz flickering electro-retinogram. Twenty-eight factors were statistically analyzed by chi-square test and logistic regression model.
Of all the 98 patients, 50 patients (51%) had poor visual outcome. There were no differences between the 2 groups in terms of sex, age of diagnosis, race, family history of BSRC, HLA-A29 positivity. Univariate analysis revealed significant associations between the poor visual outcomes group and initial visual acuity more than 0.3 LogMAR, ocular hypertension or glaucoma, cystoid macular edema, optic atrophy and duration from onset of symptoms to evaluation at MERSI of longer than 24 months. Multivariate logistic regression analysis identified only initial visual acuity more than 0.3 LogMAR, and ocular hypertension or glaucoma as independent predictors for poor visual outcome with odd ratios 4.49 (95% CI 1.49, 13.52) and 4.51 (95% CI 1.11, 18.31) respectively.
Poorer initial visual acuity and episode of ocular hypertension or glaucoma are the significant predictors of poor visual outcome of BSRC patients. This warrants prompt aggressive treatment and careful surveillance of intraocular pressure.
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