Abstract
Purpose: :
Birdshot chorioretinitis (BC) is a rare disease independently involving the retina and the choroid. Choroidal disease is rapidly responsive to inflammation suppressive therapy whereas retinitis is more resistant with deleterious functional consequences. This study aimed to follow retinal profiles in early (< 1 year, untreated); intermediate (1-6 years, receiving therapy); and late BC (> 6 years) using optical coherence tomography (OCT).
Methods: :
OCT images were retrospectively evaluated in 28 eyes, and retinal thickness was calculated in the foveola, parafoveal nasal, and temporal area; nasal and temporal mid-peripheral macula; and nasal and temporal periphery of the macula.
Results: :
14 patients with BC (4M/10W) were included in the study with a mean age at onset of 46.1 ± 7.4 years and a mean diagnostic delay of 13.9 ± 11 months. Mean follow-up was 109.5 ± 52.7 months. The HLA-A29 antigen was positive in all patients. Retinal thickness in the early BC group was significantly elevated in comparison with a group of healthy controls in all measurement points (parafoveal nasal: 437.5 ± 83.0 µm vs. 370 ± 21.7; P < .016 and parafoveal temporal : 395±62.4 µm vs. 346.7 ± 25 µm; P < .03), because of diffuse exudative retinal vasculopathy. In late disease, retinal thickness was significantly thinned at all measured locations compared with early disease (parafoveal nasal: 324.3 ± 43.8 µm vs. 437.5 ± 83 µm; P < .001 and parafoveal temporal: 310.7 ± 42.9 µm vs. 395.0 ± 62.4 µm; P < .0001); it was also significantly thinned when compared to the control group except at the level of the fovea. Epiretinal membrane (ERM) development was seen in 93% (13/14) of eyes with late BC.
Conclusions: :
The retina is thickened and exudative in early BC; thickness diminishes during intermediate BC; and retinal thinning/atrophy with a very high rate of ERM are observed in late BC.
Keywords: chorioretinitis • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • uveitis-clinical/animal model