New concepts in the appraisal and management of birdshot retinochoroiditis, a global perspective
Birdshot retinochoroiditis (BRC) is a relatively recently described entity. BRC uveitis is predominant in the posterior segment with dual, independent retinal, and choroidal inflammation. The disease has no known extra-ocular inflammation sites and yet features the strongest known HLA association: HLA-A29 is present in close to 100 % of cases. Aim in this mini-review was to readjust the appraisal of BRC in the light of a global approach including the full array of investigational procedures. Historical background and the genesis of the disease name were searched. Global disease description including both the retina and the choroid was given. Retinal involvement was clearly characterized, pointing toward the profuse leakage of retinal vessels of all sizes in early disease and widespread atrophy in under treated patients. The importance of exploration of choroidal disease, unavailable until the early 1990s before the advent of indocyanine green angiography (ICGA) was stressed, allowing early diagnosis of disease. Despite its proven importance to explore the choroid, ICGA is still sparsely used. Existing diagnostic criteria were found to be clearly inappropriate not allowing early diagnosis and are in need to be revised, taking into account both retinal and choroidal aspects of the disease, in order to make early diagnosis possible and hence allow proper management .
KeywordsBirdshot retinochoroiditis Indocyanine green angiography Optical coherence tomography Visual field Early diagnosis of birdshot retinochoroiditis Clinical phenotype
- 8.Papadia M, Knecht PB, Herbort CP. (2013) Early and sustained treatment modifies the phenotype of birdshot retinochoroiditis. Acta Ophthalmol 91( s252). doi: 10.1111/j.1755-3768.2013.xGoogle Scholar
- 14.Bouchenaki N, Herbort CP (2004) Stromal choroiditis. In: Pleyer U, Mondino B (eds) Essentials in ophthalmology: uveitis and immunological disorders. Springer, Berlin, pp 234–253Google Scholar
- 38.The American academy of ophthalmology basic and clinical science course, The Foundation of the American Academy of Ophthalmology, San Francisco (Pub.), Volume 9, Intraocular Inflammation and uveitis, 2000–2001 Edition, pp 170–1Google Scholar
- 39.Nussenblatt RB, Wuitcup SM, Palestine AG. Birdshot retinochoroidopathy. In Uveitis, fundamentals and clinical practice, 2nd edition. Mosby, St.-Louis 1996; pp 325–333Google Scholar