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D. Monnet, C. Pagnoux, A. Mahr, P. Cohen, R. D. Levinson, A. P. Brézin, L. Guillevin; Extra-Ocular Manifestations in Birdshot Chorioretinopathy. Results of the First Evaluation in a French Cohort of 118 Patients. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5153.
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To assess extra-ocular manifestations in birdshot chorioretinopathy.
In a single center, 118 patients with birdshot chorioretinopathy have been seen in the Department of ophthalmology, at Hôpital Cochin, Paris, France, within a yearly dedicated week in November 2002, 2003, 2004 or 2005 for the enrolement and the follow-up of a longitudinal cohort study. All patients had a standardized and consistent evaluation, to avoid introduction of bias, and performed within one single day. Medical interviews and data records were performed by 4 trained specialists from the department of internal medicine in a standardized form. Methodical questions were asked for, using a record book, which has already been used by the French Vasculitis Study Group in clinical trials in systemic vasculitides. Specific attention was accorded to the clinical symptoms noted concomitantly to the onset of the first ophthalmologic signs (+/- 6 months). For patients’ characteristics at the time of the evaluation, symptoms that could be attributed to treatment side effects were clearly differentiated from others more clearly ‘non-iatrogenic’ manifestations.
Mean age of the 118 enrolled patients was 49.7 years at the time of the first symptoms, and 51.5 at diagnosis, with M/F ratio 0.38. Among personal medical history, more common features were hypertension (32 patients), drug allergy (19), sinusitis (17), thyroid diseases (12), otitis media, asthma, cancer (11 for each) and diabetes (10). One patient had antiphospholipid syndrome. Psoriasis was known in 5 patients. Eight had history of cancer and 3 had benign monoclonal gammapathy. Dust exposure was noted in 20 and tobacco use in 57. Three were brothers. At the onset of first symptoms, arthralgia were noted in 23, and ENT manifestations in 26 patients, with hearing loss or sudden deafness in 8. Raynaud’s phenomenon was described by 9. Headaches were noted in 10 and 13 had minor depression and/or anxiety. Three new patients developed psoriasitic lesions. None of the patients had ANCA or biological inflammation.
Demographics of our patients correspond to those of earlier series. We could not identify any outstandingly frequent extra-ocular manifestation. However, some findings deserve attention, like hypoacousia, allergy, diabetes, psoriasis and associated auto-immune diseases.
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