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E. H. Hughes, E. M. Graham, C. Edelsten, M. R. Stanford; Birdshot Chorioretinopathy - Long Term Follow-Up. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5142.
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Birdshot Chorioretinopathy (BCR) is a chronic, idiopathic intra-ocular inflammation that often results in progressive visual loss and may require prolonged use of immunosuppressive agents. Several series present data on medium-term follow-up but there is little published data with greater than 5-year follow-up. This study describes the long-term outcome in our series of BCR patients.
Retrospective case notes review of BCR patients followed up at the Medical Eye Unit, St. Thomas’ Hospital for more than 5 years. Snellen visual acuity, colour vision (Ishihara plates), visual field and presence of sight-threatening complications were the cardinal data collected.
12 patients were included with median duration of follow-up 11 years (7-24). 8 patients were male and mean age at onset of symptoms was 46 yrs (28-63). Colour vision was abnormal in 9/24 eyes (38%) at presentation and in all eyes at 10 years. 60% eyes had an abnormal visual field at diagnosis with 91% being abnormal by 10 years. The main cause of reduced visual acuity was cystoid macular oedema which was present in 4/24 eyes (17%) at presentation and eventually present at some stage in 17/24 eyes (71%). Visual acuity (VA) at diagnosis was 6/6 or better in 54% eyes and 6/12 or better in 88%. After 10 years follow-up VA was 6/6 or better in 7% and 6/12 or better in 66%. 2 patients (17%) had final VA <6/60 bilaterally.
Loss of visual acuity occurs later than colour and field loss. The early complications of colour and field loss mostly occur within two years of symptoms, with all patients eventually developing abnormal colour vision, regardless of visual acuity. Cystoid macular oedema was the main cause of visual loss. Only 2 patients (17%) became bilaterally blind.
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