Unilateral birdshot-like choroidopathy: a case report

To report on an unusual case of unilateral birdshot-like choroidopathy and to describe its clinical characteristics.

Prospective follow-up study of clinical, laboratory, electrophysiologic, and angiographic evolution of a patient with choroidal lesions mimicking birdshot chorioretinitis.

Visual acuity, serial visual fields, spectral domain optical coherent tomography, electrophysiologic studies: full-field electroretinogram, pattern electroretinogram, multifocal electroretinogram, and electrooculogram. Fluorescein angiography, indocyanine green angiography, color vision and contrast sensitivity studies.

Observational case report.

At 30 months of follow-up, visual acuity was 20/20 in both eyes. There were no signs of intraocular inflammation at any time over follow-up. Serial visual field showed no abnormality. Electrophysiologic studies reflected normal retinal function. Color vision and contrast sensitivity were both normal. Fluorescein angiography depicted unilateral hypofluorescent choroidal spots in early phases becoming hyperfluorescent in late frames without changes over follow-up. Indocyanine green angiography pointed out diffuse hypofluorescent choroidal lesions in early and late frames that did not modify over follow-up.

We present an interesting but unusual case of idiopathic unilateral choroidal lesions mimicking those seen in birdshot chorioretinitis but without evidence of active inflammation. Our case has been called unilateral birdshot-like choroidopathy on the basis of the characteristics of the lesions and the lack of active inflammation. The patient has been followed up for 30 months without treatment, and no changes in visual function or clinical features have been observed. Clinicians should be aware of the diagnostic criteria of birdshot chorioretinitis to avoid unnecessary treatment of patients with other diseases mimicking birdshot.