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C. Stathopoulos, A. P. Brézin, D. Monnet; Analysis of Peripapillary Area Among Birdshot Patients. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5887.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the peripapillary area in a cohort of patients with birdshot chorioretinopathy.
Materials and Methods: :
A cohort of 142 patients (58 men, 84 women, 284 eyes) has been evaluated in October 2008. All patients were HLA-29 positive. The mean age was 58.4 +/-10.9 years. Color optic disc photographs were examined morphometrically to measure peripapillary alpha and beta atrophy. Peripapillary birdshot spots were analyzed in a systematic manner. Birdshot spots were defined as peripapillary when they were in contact with the optic nerve or confluent with a zone of peripapillary atrophy. For all assessments, the optic nerve head, the intra- and peripapillary areas were divided into four sectors: inferior and superior temporal sectors were right-angled, and their middle lines were tilted 13 degrees temporal to the vertical optic disc axis. The temporal horizontal sector (64 degrees) and the nasal sector (116 degrees) covered the remaining areas. Visual field testing (Full-threshold Humphrey 30-2) was performed for both eyes of all patients.
Single-center cross-sectionnal study
Twenty-one eyes were excluded due to poor image quality. Twelve eyes were treated for glaucoma and 5 eyes had elevated IOP (>21 mmHg) at the time of evaluation. High myopia of more than beyond -6 diopters was present in seven eyes. Peripapillary birdshot spots were found in 113 of 263 eyes (43%), corresponding to 72 patients (51%). Peripapillary lesions were bilateral in 41 patients, and unilateral in 31 patients. Birdshot peripapillary spots were more frequent and equally distributed in the nasal and inferior quadrants (45%, 116 spots). A peripapillary atrophy was observed in 239 eyes (83,8%), including 164 eyes (68,5%) with alpha atrophy and 135 eyes (56,7%) with beta atrophy. In 92,2% (108 eyes), peripapillary birdshot spots were associated with peripapillary atrophy. In 6,1% (7 eyes) peripapillary spots were present without any type of peripapillary atrophy.
Birdshot chorioretinopathy peripapillary abnormalities were systematically analyzed for the first time. Peripapillary birdshot lesions and atrophy appeared common and could be used to facilitate diagnosis of birdshot chorioretinopathy.
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