Birdshot chorioretinopathy

Abstract

Progress has been made in understanding the spectrum of manifestations of birdshot chorioretinopathy. The disease remains of unknown cause and many decisions regarding the management of patients are still empirical.

Hla-A29–positive Birdshot Chorioretinopathy in an African American Patient

“…The allele frequency of HLA-A*2902 is 0.0434 in whites and 0.0357 in African Americans. 16 The similarity in allele frequency suggests that there are other factors responsible for the disparity in terms of prevalence of this disease between populations. It is important to note that HLA-A29 positivity alone is not sufficient to make a diagnosis: a positive HLA-A29 may be useful to confirm and support the already established diagnosis based on the clinical presentation, but it has a low positive predictive value in cases where the clinical presentation is uncharacteristic for BCR.…”

“…19,20 Certain combinations of HLA loci with immunoglobulin-like receptor genes have been reported to have a strong positive association with BCR. Interestingly, these highly associated genotypes are extremely rare in African Americans, 16 possibly explaining, at least in part, the rarity of this condition in African American populations. More recently, a Th17-driven autoimmune process has been suggested to affect the pathogenesis of BCR 21 and increased IL-17 has been reported in the aqueous humor of BCR patients.…”

Treatment of Cystoid Macular Edema in a Patient With Birdshot Chorioretinopathy With Bevacizumab

“…1 The disease carries the strongest known link to any human leukocyte antigen Class I allele. 3 Other conditions such as syphilis and sarcoidosis must be ruled out. 4 Most treatment regimens include some combination of systemic or periocular corticosteroids, methotrexate, mycophenolate mofetil, daclizumab, and other systemic immunosuppressants.…”

Functional outcome of macular edema in different retinal disorders

“…Retinal electrophysiology is a very useful tool not only to examine foveal function, particularly in uncooperative patients or those with a severely reduced visual function, but also in order to differentiate optic nerve and retinal disease, detect retinal dystrophies and estimate peripheral retinal function when the disease continues to progress in the retinal periphery, despite preserved central foveal function. In cases of retinal dystrophies such as retinitis pigmentosa (Hartong et al, 2006) or inflammatory conditions like birdshot chorioretinopathy (Monnet and Br ezin, 2006;Moschos et al, 2014), the use of retinal electrophysiology is of great importance in the diagnosis, follow-up and treatment decisions for these patients. However they require specialized personnel to perform them reliably and interpret the results, such that they are currently being used sporadically rather than repeatedly in the clinic and mainly for long term assessment of disease progression and treatment adjustment.…”