Abstract
Birdshot chorioretinopathy is a well-known, yet poorly understood, form of posterior uveitis, characterized by multiple, distinctive, hypopigmented choroidal lesions, and strongly associated with human leukocyte antigen (HLA)-A29. We reviewed all English language publications regarding birdshot chorioretinopathy and performed analyses of combined patient data taken from these articles. The mean age at presentation was 53 years, with a slight female predominance (54.1%). At least 95.7% of reported patients have been HLA-A29-positive. Blurring of vision and floaters are the most prevalent presenting complaints, even in patients with visual acuity of 20/20 or better in both eyes. Birdshot chorioretinopathy is a slowly progressive disease with profound dysfunction of vision that may not be reflected in Snellen visual acuity. Two or more lines of Snellen visual acuity were lost in approximately 20% of eyes over a median follow-up of 3.5 years; macular edema was the most common cause of reduced visual acuity. Overall, patients had a slow decline in visual acuity, despite the fact that nearly all were treated with anti-inflammatory therapies. Final visual acuity in the better eye was 20/40 or better in 75.1% of patients and 20/200 or worse in 9.8% of patients. Oral corticosteroids and cyclosporine were the most commonly used medications. Using a regression model, patients in the literature that have been treated with cyclosporine alone had better final visual acuity than patients treated with oral corticosteroids alone. Further study is needed to determine the optimal methods for treating and monitoring patients with birdshot chorioretinopathy.
| Original language | English |
|---|---|
| Pages (from-to) | 519-541 |
| Number of pages | 23 |
| Journal | Survey of Ophthalmology |
| Volume | 50 |
| Issue number | 6 |
| DOIs | |
| State | Published - Nov 1 2005 |
| Externally published | Yes |
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Keywords
- Birdshot chorioretinopathy
- Choroidal lesions
- HLA-A29
- Optic disk edema
- Posterior uveitis
- Retinal vasculitis
- Vitiliginous chorioretinitis
ASJC Scopus subject areas
- Ophthalmology
Cite this
Birdshot chorioretinopathy. / Shah, Kayur H.; Levinson, Ralph D.; Yu, Fei; Goldhardt, Raquel; Gordon, Lynn K.; Gonzales, Christine R.; Heckenlively, John R.; Kappel, Peter J.; Holland, Gary N.
In: Survey of Ophthalmology, Vol. 50, No. 6, 01.11.2005, p. 519-541.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Birdshot chorioretinopathy
AU - Shah, Kayur H.
AU - Levinson, Ralph D.
AU - Yu, Fei
AU - Goldhardt, Raquel
AU - Gordon, Lynn K.
AU - Gonzales, Christine R.
AU - Heckenlively, John R.
AU - Kappel, Peter J.
AU - Holland, Gary N.
PY - 2005/11/1
Y1 - 2005/11/1
N2 - Birdshot chorioretinopathy is a well-known, yet poorly understood, form of posterior uveitis, characterized by multiple, distinctive, hypopigmented choroidal lesions, and strongly associated with human leukocyte antigen (HLA)-A29. We reviewed all English language publications regarding birdshot chorioretinopathy and performed analyses of combined patient data taken from these articles. The mean age at presentation was 53 years, with a slight female predominance (54.1%). At least 95.7% of reported patients have been HLA-A29-positive. Blurring of vision and floaters are the most prevalent presenting complaints, even in patients with visual acuity of 20/20 or better in both eyes. Birdshot chorioretinopathy is a slowly progressive disease with profound dysfunction of vision that may not be reflected in Snellen visual acuity. Two or more lines of Snellen visual acuity were lost in approximately 20% of eyes over a median follow-up of 3.5 years; macular edema was the most common cause of reduced visual acuity. Overall, patients had a slow decline in visual acuity, despite the fact that nearly all were treated with anti-inflammatory therapies. Final visual acuity in the better eye was 20/40 or better in 75.1% of patients and 20/200 or worse in 9.8% of patients. Oral corticosteroids and cyclosporine were the most commonly used medications. Using a regression model, patients in the literature that have been treated with cyclosporine alone had better final visual acuity than patients treated with oral corticosteroids alone. Further study is needed to determine the optimal methods for treating and monitoring patients with birdshot chorioretinopathy.
AB - Birdshot chorioretinopathy is a well-known, yet poorly understood, form of posterior uveitis, characterized by multiple, distinctive, hypopigmented choroidal lesions, and strongly associated with human leukocyte antigen (HLA)-A29. We reviewed all English language publications regarding birdshot chorioretinopathy and performed analyses of combined patient data taken from these articles. The mean age at presentation was 53 years, with a slight female predominance (54.1%). At least 95.7% of reported patients have been HLA-A29-positive. Blurring of vision and floaters are the most prevalent presenting complaints, even in patients with visual acuity of 20/20 or better in both eyes. Birdshot chorioretinopathy is a slowly progressive disease with profound dysfunction of vision that may not be reflected in Snellen visual acuity. Two or more lines of Snellen visual acuity were lost in approximately 20% of eyes over a median follow-up of 3.5 years; macular edema was the most common cause of reduced visual acuity. Overall, patients had a slow decline in visual acuity, despite the fact that nearly all were treated with anti-inflammatory therapies. Final visual acuity in the better eye was 20/40 or better in 75.1% of patients and 20/200 or worse in 9.8% of patients. Oral corticosteroids and cyclosporine were the most commonly used medications. Using a regression model, patients in the literature that have been treated with cyclosporine alone had better final visual acuity than patients treated with oral corticosteroids alone. Further study is needed to determine the optimal methods for treating and monitoring patients with birdshot chorioretinopathy.
KW - Birdshot chorioretinopathy
KW - Choroidal lesions
KW - HLA-A29
KW - Optic disk edema
KW - Posterior uveitis
KW - Retinal vasculitis
KW - Vitiliginous chorioretinitis
UR - http://www.scopus.com/inward/record.url?scp=27444434792&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=27444434792&partnerID=8YFLogxK
U2 - 10.1016/j.survophthal.2005.08.004
DO - 10.1016/j.survophthal.2005.08.004
M3 - Article
C2 - 16263368
AN - SCOPUS:27444434792
VL - 50
SP - 519
EP - 541
JO - Survey of Ophthalmology
JF - Survey of Ophthalmology
SN - 0039-6257
IS - 6
ER -