Symptoms, Quality of Life and Functional Assessment of Patients with Birdshot Retinochoroidopathy

Abstract

Abstract: : Purpose: To correlate quality of life and visual symptoms with visual acuity and a panel of adjunctive examinations for the functional assessment of patients with birdshot retinochoroidopathy Methods: Cross sectional case series of 46 patients with birdshot retinochoroidopathy. Patients were seen at a single point in time at one institution. Examinations were performed in the following order: National Eye Institute Visual Function Questionnaire–25 (VFQ–25), refraction for best corrected visual acuity (BCVA), Lanthony 15–hue desaturated test (L15), Humphrey visual field (HVF), optical coherence tomography (OCT), fluorescein angiography and clinical ophthalmologic examination. A systematic review of symptoms and history of extraocular disease was obtained by physicians specializing in internal medicine. Results: The most commonly identified medical conditions were allergy and systemic hypertension. The mean number of visual complaints was 3 (range 0 – 6). Only one patient did not report visual symptoms. Indeed, all 10 patients with a BCVA of 20/20 or better in both eyes had visual symptoms. Floaters were the most common symptom and reported more often by patients with a shorter duration of disease (p=0.056). Conversely, difficulty with color vision increased with duration of disease (p=0.032). The composite VFQ–25 score was lower among patients even for the subgroup of patients with a BCVA of 20/20 than a published reference group; the greatest difference was in the mental health subscale (p<0.001). There was a better correlation between visual symptoms or lower VFQ–25 scores and abnormal L15 and HVF examinations than with the BCVA and OCT results. VFQ–25 scores were lower and mean deviation on HVF more negative in 9 patients never treated. Conclusions: Adjunctive examinations provide insight into the functional status of patients with birdshot retinochoroidopathy not provided by visual acuity measurements.

Keywords: autoimmune disease • clinical (human) or epidemiologic studies: outcomes/complications • quality of life