Birdshot retinochoroidopathy

Gasch, Alice T.; Smith, Janine A.; Whitcup, Scott M.

doi:10.1136/bjo.83.2.241

Cited by 111 publications

(68 citation statements)

References 41 publications

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“…This disease usually affects Caucasian women from northern Europe in their fourth decade of life (Priem & Oosterhuis 1988;Gasch et al 1999;Shah et al 2005). Although there have been many publications in the literature over the last thirty years, birdshot disease is still not well understood, especially in terms of its physiopathogenic mechanisms.…”

Section: Introductionmentioning

confidence: 99%

Relevance of wide‐field autofluorescence imaging in Birdshot retinochoroidopathy: descriptive analysis of 76 eyes

Piffer

Boissonnot

Gobert

et al. 2013

Acta Ophthalmologica

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ABSTRACT.Purpose: To study and classify retinal lesions in patients with birdshot disease using wide-field autofluorescence imaging and correlate them according to patients' visual status. Methods: A multicentre study was carried out on 76 eyes of 39 patients with birdshot disease, analysing colour images and under autofluorescence using the wide-field Optomap â imaging system. This was combined with a complete clinical exam and analysis of the macula with OCT. Results: In over 80% of the eyes, a chorioretinal lesion has been observed under autofluorescence with a direct correlation between the extent of the lesion and visual status. The presence of macular hypo-autofluorescence was correlated with a decreased visual acuity, due to the presence of a macular oedema, active clinical inflammation or an epiretinal membrane. The hypo-autofluorescence observed correlated with the duration of the disease and the degree of inflammation in the affected eye, indicating a secondary lesion in the pigment epithelium in relation to the choroid. The pigment epithelium was affected in a diffuse manner, as in almost 50% of the eyes the wider peripheral retina was affected. Conclusion: Wide-field autofluorescence imaging could appear to be a useful examination when monitoring patients, to look for areas of macular hypoautofluorescence responsible for an irreversible loss of vision.

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Section: Introductionmentioning

confidence: 99%

Relevance of wide‐field autofluorescence imaging in Birdshot retinochoroidopathy: descriptive analysis of 76 eyes

Piffer

Boissonnot

Gobert

et al. 2013

Acta Ophthalmologica

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“…Sua patogê-nese é desconhecida, mas há forte associação com o antígeno HLA-A29 (9,(49)(50) . Esse antígeno, presente em 80-98% dos pacientes, aumenta significativamente o risco para RBS e sua positividade serve como diagnóstico diferencial com outras enfermidades de acometimentos oftalmológicos semelhantes, como sífilis, tuberculose e sarcoidose (50)(51) . A aparência amarelada do fundo do olho e a presença do antígeno HLA-A29 indicam o diagnóstico da patologia (52) .…”

Section: Retinocoroidopatia "Birdshot"unclassified

“…Existem dois subtipos de antígenos HLA-A29 (-A29.1 e -A29.2), sendo que o segundo é o predominante em pacientes com RBS (53)(54) . Não se sabe, no entanto, se sua maior prevalência se deva a uma real associação com a doença ou se ocorre pelo fato de ele ser mais comum na população geral (50) . Especula-se que o antígeno HLA-A29.1 seja uma mutação do -A29.2 e que essa mutação confira resistência à RBS, inibindo a interação dessas molécu-las com linfócitos T e conseqüente ativação dessas células (50) .…”

Section: Retinocoroidopatia "Birdshot"unclassified

“…Não se sabe, no entanto, se sua maior prevalência se deva a uma real associação com a doença ou se ocorre pelo fato de ele ser mais comum na população geral (50) . Especula-se que o antígeno HLA-A29.1 seja uma mutação do -A29.2 e que essa mutação confira resistência à RBS, inibindo a interação dessas molécu-las com linfócitos T e conseqüente ativação dessas células (50) . Mas isso ainda é controverso, sendo que alguns estudos sugerem que ambos os antígenos estão igualmente associados à susceptibilidade (9) .…”

Section: Retinocoroidopatia "Birdshot"unclassified

“…Boisgérault et al (1996) sugeriram que antígenos próprios da retina dos pacientes, com afinidade pelas moléculas HLA-A29, funcionariam como auto-antígenos, implicando em RBS auto-imune (9) . Suspeita-se também da participação de agentes infecciosos na patogênese que ao inserir seus epítopos em moléculas HLA-A29 do hospedeiro, facilitariam a apresentação dessas moléculas próprias do organismo aos linfócitos T citotóxicos, gerando doença auto-imune (50) . Uma síndrome associada ao antígeno HLA-A29 foi sugerida por Bloch-Michel, Frau, (1991), englobando a RBS e outras condições cuja expressão pode ser geneticamente determinada, como envolvimento do pólo posterior do globo ocular, curso severo da doença e prognóstico ruim, apesar da terapia com corticóide (53) .…”

Section: Retinocoroidopatia "Birdshot"unclassified

See 2 more Smart Citations

Associação do sistema de histocompatibilidade humano com doenças oftalmológicas

Alves¹,

Meyer²,

Toralles³

et al. 2006

Arq. Bras. Oftalmol.

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Characterization of Birdshot Chorioretinopathy Using Extramacular Enhanced Depth Optical Coherence Tomography

Keane

Allie²,

Turner³

et al. 2013

JAMA Ophthalmol

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To combine "extramacular" and "enhanced depth" optical coherence tomographic (OCT) scanning protocols to facilitate enhanced characterization of patients with birdshot chorioretinopathy. Methods: Spectral-domain OCT images were prospectively collected from 24 eyes of 12 patients with birdshot chorioretinopathy. The images were acquired both from the macula and from 4 peripheral locations: superior and inferior to the temporal vascular arcades, nasal to the optic disc, and temporal to the macula. All images were obtained using enhanced depth scanning protocols. Qualitative and quantitative assessments were performed and compared with those from healthy, agematched controls. Results: Generalized loss of the photoreceptor inner segment/outer segment junction was seen more frequently on extramacular OCT image sets. Focal loss of the inner segment/outer segment junction was seen most commonly on inferior extramacular images. Generalized thinning and loss of retinal architecture, accompanied by outer retinal hyperreflective foci, were also commonly seen on extramacular scans. Assessment of choroidal morphology included thinning/absence of the Sattler layer, generalized thinning, discrete hyperreflective foci, focal depigmentation, and the presence of suprachoroidal hyporeflective space. The mean (SD) foveal choroidal thickness was significantly less for patients with birdshot chorioretinopathy (276 [101] m) than for controls (337 [74] m) (P =.04). Conclusions: The OCT images obtained outside the macula often show significant retinal and choroidal changes in cases for which conventional OCT scans appear unremarkable. Use of extramacular scanning may thus allow improved phenotyping of uveitic disorders such as birdshot chorioretinopathy. Evaluation of the photoreceptor inner segment/outer segment junction, using this approach, may be of value for monitoring disease activity in clinical practice and as a surrogate end point in clinical trials.

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Birdshot retinochoroidopathy

Cited by 111 publications

References 41 publications

Relevance of wide‐field autofluorescence imaging in Birdshot retinochoroidopathy: descriptive analysis of 76 eyes

Relevance of wide‐field autofluorescence imaging in Birdshot retinochoroidopathy: descriptive analysis of 76 eyes

Associação do sistema de histocompatibilidade humano com doenças oftalmológicas

Characterization of Birdshot Chorioretinopathy Using Extramacular Enhanced Depth Optical Coherence Tomography

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