Unilateral birdshot-like choroidopathy: a case report

Area of Science:

• Ophthalmology
• Retinal Diseases
• Choroidal Pathologies

Background:

• Birdshot chorioretinitis is a rare, bilateral inflammatory condition affecting the choroid and retina.
• Differential diagnosis is crucial to distinguish it from other conditions with similar clinical presentations.

Purpose of the Study:

• To present an unusual case of unilateral choroidal lesions resembling birdshot chorioretinitis.
• To detail the clinical, electrophysiologic, and angiographic characteristics of this condition.

Main Methods:

• Prospective observational case report.
• Comprehensive evaluation including visual acuity, visual fields, spectral domain optical coherent tomography, and electrophysiologic testing (full-field electroretinogram, pattern electroretinogram, multifocal electroretinogram, electrooculogram).
• Advanced imaging with fluorescein angiography and indocyanine green angiography, alongside color vision and contrast sensitivity assessments.

Main Results:

• The patient exhibited 20/20 visual acuity and normal retinal function throughout 30 months of follow-up.
• No intraocular inflammation was detected.
• Angiography revealed characteristic unilateral hypofluorescent choroidal spots (fluorescein) and diffuse hypofluorescent lesions (indocyanine green) without progression.

Conclusions:

• The described condition, termed unilateral birdshot-like choroidopathy, mimics birdshot chorioretinitis but lacks active inflammation.
• The patient remained stable without treatment, highlighting the importance of accurate diagnosis.
• Awareness of diagnostic criteria for birdshot chorioretinitis is essential to prevent misdiagnosis and unnecessary treatment.