Skip to main content
SpringerLink
Log in

Birdshot Retinochoroidopathy (Vitiliginous Chorioretinitis)

  • Living reference work entry
  • First Online:
Encyclopedia of Ophthalmology

  • 213 Accesses

Synonyms

Vitiliginous chorioretinitis (no longer used)

Definition

Birdshot retinochoroidopathy (BSRC) is a rare distinct intraocular inflammatory condition. It is characterized by the presence of multiple cream-colored round or oval choroidal lesions in the post-equatorial region, mainly the peripapillary area at the level of the outer retina/choroid. The lesions appear in a pattern resembling the scatter of birdshot pellets from a shotgun (Nussenblatt et al. 1982; Priem et al. 1988).

Pathogenesis

BSRC is considered a T-cell-mediated disease. Findings of higher than normal levels of IL-17 in the serum and aqueous humor of affected patients suggest that the Th17 subset is involved in the pathogenesis of BSRC (Miossec et al. 2009; Brezin et al. 2011). About 95 % of patients with BSRC are positive for HLA A-29 – the highest class 1 haplotype association of any disease – but its pathogenic role remains unclear. Molecular mimicry triggered by antecedent infection is a popular hypothesis.

Epidemiology...

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  • Artornsombudh P, Gevorgyan O, Payal A, Siddique SS, Foster CS (2013) Infliximab treatment of patients with birdshot retinochoroidopathy. Ophthalmology 120:588–592

    Article  PubMed  Google Scholar 

  • Brezin AP, Monnet D, Cohen JH, Levinson RD (2011) HLA-A29 and birdshot chorioretinopathy. Ocul Immunol Inflamm 19:397–400

    Article  PubMed  Google Scholar 

  • Fardeau C, Herbort CP, Kullmann N, Quentel G, LeHoang P (1999) Indocyanine green angiography in birdshot chorioretinopathy. Ophthalmology 106:1928–1934

    Article  CAS  PubMed  Google Scholar 

  • Forooghian F, Gulati N, Jabs DA (2010) Restoration of retinal architecture following systemic immunosuppression in birdshot chorioretinopathy. Ocul Immunol Inflamm 18:470–471

    Article  PubMed  Google Scholar 

  • Herbort CP, Probst K, Cimino L, Tran VT (2004) Differential inflammatory involvement in retina and choroïd in birdshot chorioretinopathy. Klin Monbl Augenheilkd 221:351–356

    Article  CAS  PubMed  Google Scholar 

  • Holder GE, Robson AG, Pavesio C, Graham EM (2005) Electrophysiological characterisation and monitoring in the management of birdshot chorioretinopathy. Br J Ophthalmol 89:709–718

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Koizumi H, Pozzoni MC, Spaide RF (2008) Fundus autofluorescence in birdshot chorioretinopathy. Ophthalmology 115:e15–e20

    Article  PubMed  Google Scholar 

  • Levinson RD, Brezin A, Rothova A, Accorinti M, Holland GN (2006) Research criteria for the diagnosis of birdshot chorioretinopathy: results of an International Consensus Conference. Am J Ophthalmol 141:185–187

    Article  Google Scholar 

  • Lowder C, Belfort R, Lightman S, Foster CS, Robinson MR, Schiffman RM, Li XY, Cui H, Whitcup SM, Ozurdex HURON Study Group (2011) Dexamethasone intravitreal implant for noninfectious intermediate or posterior uveitis. Arch Ophthalmol 129:545–553

    Article  PubMed  Google Scholar 

  • Miossec P, Korn T, Kuchroo VK (2009) Interleukin-17 and type 17 helper T cells. N Engl J Med 361:888–898

    Article  CAS  PubMed  Google Scholar 

  • Nussenblatt RB, Mittal KK, Ryan S, Green WR, Maumenee AE (1982) Birdshot retinochoroidopathy associated with HLA-A29 antigen and immune responsiveness to retinal S-antigen. Am J Ophthalmol 94:147–158

    Article  CAS  PubMed  Google Scholar 

  • Priem HA, Kijlstra A, Noens L, Baarsma GS, De Laey JJ, Oosterhuis JA (1988) HLA typing in birdshot chorioretinopathy. Am J Ophthalmol 105:182–185

    Article  CAS  PubMed  Google Scholar 

  • Rothova A, Berendschot TT, Probst K, van Kooij B, Baarsma GS (2004) Birdshot chorioretinopathy: long-term manifestations and visual prognosis. Ophthalmology 111:954–959

    Article  PubMed  Google Scholar 

  • The Multicenter Uveitis Steroid Treatment (MUST) Trial Research Group, Writing Committee, Kempen JH, Altaweel MM, Holbrook JT, Jabs DA, Louis TA, Sugar E, Thorne JE (2011) Randomized comparison of systemic anti-inflammatory therapy versus fluocinolone acetonide implant for intermediate, posterior, and panuveitis: the Multicenter Uveitis Steroid Treatment Trial. Ophthalmology 118:1916–1926

    Article  Google Scholar 

  • Tomkins-Netzer O, Taylor SRJ, Lightman S (2014) Long-term clinical and anatomic outcome of birdshot chorioretinopathy. JAMA Ophthalmol 132:57–62

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Head, Uveitis Service, Department of Ophthalmology, Rabin Medical Center, 49100, Petah-Tikva, Israel

    Michal Kramer

  2. Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel

    Michal Kramer

Authors
  1. Michal Kramer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michal Kramer .

Editor information

Editors and Affiliations

  1. Dept of Ophthal & Optometry,AKH, Medical University of Wien Dept of Ophthal & Optometry,AKH, Wien, Austria

    Ursula Schmidt-Erfurth

  2. Department of Ophthalmology, Goethe University of Frankfurt am Main Department of Ophthalmology, Frankfurt am Main, Germany

    Thomas Kohnen

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this entry

Cite this entry

Kramer, M. (2015). Birdshot Retinochoroidopathy (Vitiliginous Chorioretinitis). In: Schmidt-Erfurth, U., Kohnen, T. (eds) Encyclopedia of Ophthalmology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35951-4_1086-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-35951-4_1086-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Online ISBN: 978-3-642-35951-4

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation