Birdshot Chorioretinopathy

Definition

Definition of Birdshot Chorioretinopathy
Birdshot chorioretinopathy, also called birdshot retinochoroidopathy, is a rare form of bilateral posterior uveitis affecting the eye. It causes severe, progressive inflammation of both the choroid and retina.

Symptoms

Symptoms of Birdshot Chorioretinopathy
Symptoms of this disorder include: abundant floaters, uveitis, chorioretinitis, retinitis, papillitis, retinal vasculitis, vitreous inflammation, macular edema, "flashing" lights in eyes, nyctalopia, loss of color vision, and small light-colored spots on the retina. Complete loss of visual acuity is the common prognosis.

Causes

Causes of Birdshot Chorioretinopathy
Consult with your doctor.

Diagnosis

Diagnosis of Birdshot Chorioretinopathy
Consult with your doctor.

Treatment

Treatment of Birdshot Chorioretinopathy
Birdshot chorioretinopathy is quite resistant to treatment. Immunosuppressant therapy with corticosteroid-sparing drugs has been somewhat effective in slowing down the progressive inflammation associated with the disorder, preserving visual intregrity as much as possible. Long-term use of such medications must be closely monitored, however, due to the discomforting, and potentially debilitating and life-threatening side-effects.

Recently, the therapeutic monoclonal antibody daclizumab has proven to be a quite effective treatment option for birdshot chorioretinopathy. Substantial reduction, and even stabilization of both vitreous inflammation and retinal vasculitis has been evident via electroretinography, during daclizumab therapy. Loss of visual acuity unrelated to the inflammation caused by the disorder, however, often remains unchanged despite usage of the drug. Contraindications and adverse side-effects are always a factor, as well. Daclizumab was discontinued by Hoffman La Roche on Sept 01, 2009, and is no longer available to the US market.

Prognosis

Prognosis of Birdshot Chorioretinopathy
Approximately 97.5% of patients may have some visual symptom at baseline, with 44% having an abnormal visual field and 50-76% with abnormal EOG. Without treatment, 16-22% of patients will developed VA = 20/200 over 10 years (versus 4% in other types of uveitis). With the use of IMTs, visual acuities remain stable or improved in 78.6-89.3% while visual fields improved from a loss of 56-107° per year to a gain of 30-53° per year.

Prevention

Prevention of Birdshot Chorioretinopathy
Consult with your doctor.