Sarcoid Uveitis Simulating Birdshot Chorioretinopathy in a Child

Yıldıran, Alişan; Süllü, Yüksel; Helek, Deniz; Özkaya, Ozan

doi:10.1097/icb.0b013e3181f7455d

Cited by 4 publications

(2 citation statements)

References 15 publications

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“…Little is known about the pathophysiology of distinct posterior uveitis entities, and their heterogeneous manifestations can make it difficult to come to an accurate diagnosis 32 . For example, birdshot chorioretinopathy and ocular sarcoidosis can look alike, as both present with granulomatous inflammation of the choroid and with retinal vasculitis 33 , 34 . Our study shows that Color-FAF imaging may aid in differentiating between birdshot chorioretinopathy and ocular sarcoidosis based on significantly different GEFC/REFC ratios and by means of the intensity-normalized Color-FAF image.…”

Section: Discussionmentioning

confidence: 99%

Spectrally resolved autofluorescence imaging in posterior uveitis

Wintergerst

Merten

Berger

et al. 2022

Sci Rep

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Clinical discrimination of posterior uveitis entities remains a challenge. This exploratory, cross-sectional study investigated the green (GEFC) and red emission fluorescent components (REFC) of retinal and choroidal lesions in posterior uveitis to facilitate discrimination of the different entities. Eyes were imaged by color fundus photography, spectrally resolved fundus autofluorescence (Color-FAF) and optical coherence tomography. Retinal/choroidal lesions’ intensities of GEFC (500–560 nm) and REFC (560–700 nm) were determined, and intensity-normalized Color-FAF images were compared for birdshot chorioretinopathy, ocular sarcoidosis, acute posterior multifocal placoid pigment epitheliopathy (APMPPE), and punctate inner choroidopathy (PIC). Multivariable regression analyses were performed to reveal possible confounders. 76 eyes of 45 patients were included with a total of 845 lesions. Mean GEFC/REFC ratios were 0.82 ± 0.10, 0.92 ± 0.11, 0.86 ± 0.10, and 1.09 ± 0.19 for birdshot chorioretinopathy, sarcoidosis, APMPPE, and PIC lesions, respectively, and were significantly different in repeated measures ANOVA (p < 0.0001). Non-pigmented retinal/choroidal lesions, macular neovascularizations, and fundus areas of choroidal thinning featured predominantly GEFC, and pigmented retinal lesions predominantly REFC. Color-FAF imaging revealed involvement of both, short- and long-wavelength emission fluorophores in posterior uveitis. The GEFC/REFC ratio of retinal and choroidal lesions was significantly different between distinct subgroups. Hence, this novel imaging biomarker could aid diagnosis and differentiation of posterior uveitis entities.

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Section: Discussionmentioning

confidence: 99%

Spectrally resolved autofluorescence imaging in posterior uveitis

Wintergerst

Merten

Berger

et al. 2022

Sci Rep

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“… 6 These characteristic ovoid lesions can oftentimes mimic infectious entities such as syphilis and tuberculosis as well as noninfectious entities such as sarcoidosis. 7 …”

Section: Discussionmentioning

confidence: 99%

Birdshot chorioretinopathy presenting in a teenager

Lee

Smith

Goldstein

2020

American Journal of Ophthalmology Case Reports

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Purpose To describe clinical features of the youngest patient with well-documented HLA-A29-positive birdshot chorioretinopathy (BCR). Observations A 17-year-old female presented with poor night vision and floaters. Examination revealed bilateral vitritis, retinal vasculitis, and numerous cream-colored ovoid lesions in the fundus. Fluorescein angiography revealed bilateral optic disc leakage, large vessel leakage and diffuse capillary ferning. There were hundreds of small hypocyanescent spots evenly distributed in the posterior pole of both eyes on indocyanine green angiography. Workup was positive for HLA-A29.2. Systemic immunosuppression with adalimumab 40mg/0.4mL was initiated every two weeks and escalated to weekly dosing. The patient's early age of disease onset prompted evaluation of her parents. The mother's exam was normal and she was HLA-A29 negative. Examination of the father revealed peripapillary choroidal lesions as well as hypocyanescent spots on ICG. HLA-typing revealed the presence of HLA-A29.2. Conclusions and Importance BCR rarely occurs in the pediatric population. We present the youngest patient with well-documented BCR in the literature to highlight that this disease deserves consideration even in young patients. Interestingly, choroidal lesions were also found in an asymptomatic parent with HLA-A29.2 positivity.

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Birdshot Chorioretinopathy

Sen¹

2020

Whitcup and Nussenblatt's Uveitis

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Sarcoid Uveitis Simulating Birdshot Chorioretinopathy in a Child

Abstract: Sarcoidosis should be considered in a child with chorioretinal lesions resembling birdshot chorioretinopathy.

Cited by 4 publications

References 15 publications

Spectrally resolved autofluorescence imaging in posterior uveitis

Spectrally resolved autofluorescence imaging in posterior uveitis

Birdshot chorioretinopathy presenting in a teenager

Birdshot Chorioretinopathy

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