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S. R. Kedhar, J. E. Thorne, D. A. Jabs, G. B. Peters, J. P. Dunn; Visual Field Loss in Birdshot Chorioretinitis. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5151.
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To quantitate visual field loss in patients with birdshot chorioretinitis (BSCR) and to describe the effect of immunosuppressive drug therapy on such field loss in these patients.
55 patients with BSCR seen at a single academic center and evaluated from July 1984 through July 2006 were included. Clinical data were collected retrospectively. Outcome measures included initial visual field loss as defined as an abnormal Goldman visual field (GVF) score within 6 months of presentation to our clinic and during follow-up, and the rate of visual field loss as defined as the number of degrees lost per year for two isopters--the I-4 and the IV-4 isopters. For the analyses of initial visual fields, degrees of visual field lost per year were calculated as the number of degrees lost from the normal mean divided by the duration of disease up to the time of the initial GVF test. For the analyses of incidence field loss during follow-up, degrees of visual field lost per year were calculated as the total number of degrees lost in each affected eye from the initial GVF test divided by the follow-up time under observation.
Forty-eight eyes of 24 patients had a GVF performed within 6 months of presentation to our clinic and of these eyes, 75% had abnormal field scores for the I-4 isopter and 56% had abnormal field scores for the IV-4 isopter. Overall, eyes with BSCR lost 54 degrees/year in the I-4 isopter and 31 degrees/year in the IV-4 isopter prior to presentation. Of the patients that received immunosuppressive drug therapy during the follow-up period, the rate of visual field loss in affected eyes prior to treatment was 107 degrees/year for the I-4 isopter and 56 degrees/year for the IV-4 isopter, respectively. The rate of visual field gain in affected eyes after institution of immunosuppressive drug therapy was 53 degrees/year in the I-4 isopter and 30 degrees/year in the IV-4 isopter, indicating an improvement in the visual fields of treated eyes.
Visual field loss is common among patients with BSCR. Treatment with immunosuppressive drugs may reverse some of the visual field loss while therapy is employed.
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