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Birdshot chorioretinopathy
Uvea
Key Points
- •BSCR has the strongest HLA association in ophthalmology: HLA-A29 (95–98%) - negative HLA-A29 virtually rules out the diagnosis
- •Cream-coloured ovoid choroidal lesions scattered nasal/inferior to the optic disc in a birdshot scatter pattern, with vitritis and minimal anterior segment inflammation
- •CMO is the most common cause of visual loss (50–80%); ERG is the most sensitive tool for detecting subclinical disease activity and monitoring treatment response
- •Long-term steroid-sparing immunosuppression is mandatory (mycophenolate, cyclosporine, adalimumab); steroids alone cause relapse on taper
- •Almost exclusively affects middle-aged Caucasian women; bilateral always; must exclude sarcoidosis, VKH, and intraocular lymphoma
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17 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations