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Chrysoula Koutsiouki, Anthony G Robson, Graham E Holder, Angela Rees, Carlos Pavesio, Mark C Westcott; Baseline prognostic factors in patients with Birdshot retinochoriopathy( BRC) .. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4122. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To identify baseline demographic, clinical and functional prognostic factors in patients with BRC.
Retrospective chart review of 52 consecutive BCR patients (35 females,17 males), attending a tertiary referral centre (Moorfields Eye Hospital, London, UK), with a minimum of 3 years follow-up. For each patient, the functional status at final visit was determined according to 3 criteria: visual acuity, Humphrey SITA standard (HVF MD) and International standard electrophysiology (PERG P50, DA 10.0 a-wave, DA 10.0 b-wave and LA 3.0 30Hz flicker ERG amplitudes and 30Hz flicker ERG timing). Each parameter was categorized as normal, mildly or severely impaired according to previously accepted criteria. Each parameter was separately correlated with baseline prognostic features, including patient demographics, baseline functional status, and clinical features (OCT and fluorescein angiography).Analysis was performed using contingency tables (Exact analysis for sparsely populated tables), setting p < 0.01 to account for multiple tests.
Mean age at presentation was 53 years (range 34-86), with mean follow up 7.7 years (range 3 – 21). More than 80% of patients retained normal, or only mildly abnormal, visual function at the final visit, according the above parameters.Baseline factors most significantly associated (positively) with good versus poor final visit functional outcome were baseline HFA MD, DA 10.0 b- wave amplitude, the absence of retinal atrophy, LA 3.0 30Hz flicker and DA 10.0 a-wave amplitudes (all at p< 0.001). Factors weakly and inconsistently predictive were LA 3.0 30Hz ERG timing and PERG P50 amplitude (all at p<0.01). Age at presentation, baseline visual acuity, and the presence or absence of macular edema had no prognostic value. The duration of follow-up (subdivided according to tertile) did adversely affect final status for DA 10.0 ERG b-wave and LA 3.0 30Hz flicker ERG amplitudes (p< 0.01), but not for the other electrophysiological parameters, nor HFA MD or acuity.
The majority of patients received aggressive treatment and attained normal or near normal visual function. Baseline characteristics, including HVF, and some electrophysiological parameters were predictive, as was the presence of retinal atrophy. Baseline macular edema was not predictive. Longstanding disease (longer than 8.3 years) may be associated with reduction of some electrophysiological parameters
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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