Abstract
Purpose :
Birdshot's disease is a chronic posterior uveitis with highly heterogenous presentation, ranging from sight-threatening to almost asymptomatic disease. We analyzed a cohort looking for phenotypic categorization.
Methods :
Single center noninterventional cross sectional clinical study on a cohort of more than 200 patients with birshot chorioretinopathy. . All patients were seen between September to December 2015. All patients met the diagnosis criteria described by Levinson et al1, and are HLA-A29 careers. Data collection included visual symptoms, type of treatment, visual acuity (VA), clinical examination. Spots were characterized by their number, localization and visibility. The estimation of retinal atrophy was based on the presence of peripapillary atrophy, of a diffuse retinal atrophy, on the morphology of retinal vessels and the aspect of the optic nerve. All patients had an automated visual field test (Humphrey 30-2). Imaging modalities included fluoresceine-angiography and macular OCT.
Results :
Patients were classified into an inflammatory versus non inflammatory disease, atrophic versus non atrophic.In the atrophic category we identified different types of atrophy: diffuse atrophy, predominant nasal atrophy, peripapillary/pseudo-serpiginous atrophy, pseudo-retinitis pigmentosa and pseudo-albinism type. Second part of the study was to analyze parameters in each subgroups. Inflammatory presentations were associated with a younger age while, atrophic forms were correlated with a longer duration of the disease. Non-atrophic cases had a better mean visual acuity and campimetric results.
Conclusions :
The aim of our aproach is to identify homogenous groups of birdshot’s patients. This would help to determine the temporal order of various disease manfestations and the possibility that clinical heterogeneity represents « subtypes » of the disease.
Ref 1:Levinson RD, Brezin A, Rothova A et al. Research criteria for the diagnosis of birshot chorioretinopathy: results of an international consensus conference. Am J Ophthalmol 2006, 141:185-187
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.