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Published on: February 15, 2022
Long-term clinical and anatomic outcome of birdshot chorioretinopathy
Oren Tomkins-Netzer1, Simon R J Taylor2, Sue Lightman1
1Uveitis Service, Moorfields Eye Hospital, London, England 2Department of Ophthalmology, Royal Surrey County Hospital, Guildford, England 3Institute of Ophthalmology, University College of London, London, England.
Importance:
Birdshot chorioretinopathy is a chronic intraocular inflammatory disease with no uniform method to document long-term disease progression or response to treatment.
Objective:
To examine the long-term visual, clinical, and anatomic outcomes of patients with birdshot chorioretinopathy.
Design, Setting, And Participants:
A retrospective evaluation of 46 patients with birdshot chorioretinopathy treated at Moorfields Eye Hospital, London, England, was conducted. Medical records for a 19-year period (1993-2012) were reviewed.
Exposures:
Patients received no treatment, short-term (≤1 year) treatment including local or systemic corticosteroids, or long-term (>1 year) treatment including systemic corticosteroids and second-line immunosuppressive agents.
Main Outcomes And Measures:
Details regarding clinical and anatomic outcome, including best-corrected visual acuity, and visual field indices were evaluated.
Results:
Ninety-two eyes of 46 patients were monitored for a mean (SE) of 57.2 (5.8) months (445 eye-years, 17% follow-up of ≥10 years). Patients maintained a steady best-corrected visual acuity throughout the follow-up period. Some clinical indices correlated with transient worse best-corrected visual acuity, including presence of cataract (P = .05), foveal leakage on fluorescein angiography (P = .04), and increased central retinal thickness (P = .02). Serial visual field studies demonstrated that patients who received only short-term treatment had a worsening of their pattern standard deviation with time (Spearman correlation, 0.57; P = .003); for those who received long-term treatment, the pattern standard deviation remained stable (Spearman correlation, -0.24; P = .26).
Conclusions And Relevance:
Our results suggest that central visual acuity can be maintained long term in patients with birdshot chorioretinopathy. Those who receive long-term immunosuppression appear to maintain better peripheral visual fields compared with patients who receive short-term treatment.
