June 2015
Volume 56, Issue 7
ARVO Annual Meeting Abstract  |   June 2015
Author Affiliations & Notes
  • Francesco Pichi
    San Giuseppe Hospital, University Eye Clinic, Bologna, Italy
    Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH
  • Careen Y Lowder
    Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH
  • Janet L Davis
    Bascom Palmer Eye Institute, Miami, FL
  • Heena Patel
    Bascom Palmer Eye Institute, Miami, FL
  • Sara J. Haug
    West Coast Medical Retina, San Francisco, CA
  • Emmett Cunningham
    West Coast Medical Retina, San Francisco, CA
    Department of Ophthalmogy, Standford University, San Francisco, CA
  • Sunil K Srivastava
    Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH
  • Footnotes
    Commercial Relationships Francesco Pichi, None; Careen Lowder, None; Janet Davis, None; Heena Patel, None; Sara Haug, None; Emmett Cunningham, None; Sunil Srivastava, Allergan (F), Bausch & Lomb (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 6185. doi:
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      Francesco Pichi, Careen Y Lowder, Janet L Davis, Heena Patel, Sara J. Haug, Emmett Cunningham, Sunil K Srivastava; WIDE-FIELD IMAGING OF BIRDSHOT CHORIORETINOPATHY. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):6185.

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

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Purpose: To study retinal lesions in patients with birdshot chorioretinopathy using wide-field imaging and correlate them to disease progression and management.

Methods: A multicentre retrospective study was carried out on 52 eyes of 26 patients with birdshot chorioretinopathy, that underwent wide-field imaging with the Optos scanning laser ophthalmoscope and fluorescein angiography, and with the Spectralis Non-Contact Ultra-Widefield Module. This was combined with a complete clinical exam and analysis of the macula with OCT, and wide-field fundus autofluorescence images were compared to visual fields where available. The primary outcome was detection of disease activity with and without wide-field imaging. The secondary outcome was the percentage of patients whose management changed based on the availability of wide-field imaging, compared with standard examination and imaging.

Results: In 33 cases (63.5%), wide-field images revealed more retinal or chorioretinal alterations or pathologies with a farther extended demarcation than 9-field composite color fundus and fluorescein imaging. Management was altered in 7 of 26 patients (26.9%) based on the use wide-field imaging and angiography (P < .001). Wide-field fluorescein angiography revealed vasculitis not clinically evident in 38 of 52 eyes (73.1%), of which 26 with large caliber venous staining and leakage (68.4%) and 12 (31.5%) with peripheral small venule staining and leakage, peripheral retinal atrophy in 9 eyes (17.3%), optic disk leakage in 16 eyes (30.8%), macular edema with leakage in 16 eyes (30.7%). Eight patients (16 eyes) underwent wide-field fundus autofluorescence, showing multiple hyperfluorescent spots in retinal periphery in 9 eyes (56.2%). The presence of macular hypoautofluorescence in 3 patients correlated with the duration of the disease, a decreased visual acuity and the degree of inflammation in the affected eye, indicating a secondary diffuse lesion in the pigment epithelium in relation to a thinning of the choroid. Findings from wide-field FAF imaging showed correspondence to visual field defects.

Conclusions: Wide-field imaging is a valuable tool in the management of patients with birdshot chorioretinopathy and can be used for the diagnosis, treatment, and follow-up and may alter management decisions compared to standard-of-care imaging and clinical examination.


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