Birdshot chorioretinopathy

Shao, Emily Han; Menezo, Víctor; Taylor, Simon

doi:10.1097/icu.0000000000000101

Cited by 19 publications

(10 citation statements)

References 51 publications

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“…BCR is strongly associated with HLA-A29 allele and it is believed to be T-cell driven. Typical manifestations include bilateral non- granulomatous uveitis with deep peripapillary or diffuse hypopigmented characteristic multiple cream-colored, irregular choroidal lesions 34Sympathetic ophthalmia.…”

Section: Etiology Of Non-infectious Umementioning

confidence: 99%

<p>Macular edema associated with non-infectious uveitis: pathophysiology, etiology, prevalence, impact and management challenges</p>

Massa

Pipis

Adewoyin

et al. 2019

OPTH

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Macular edema (ME) is the most common sight-threatening complication in uveitis. The diagnostic and therapeutic management of the uveitic macular edema (UME) might be challenging due to the complex diagnostic workup and the difficulties physicians face to find the underlying cause, and due to its usually recurrent nature and the fact that it can be refractory to conventional treatment. Some of the mild cases can be treated with topical steroids, which can be combined with non-steroid anti-inflammatory drugs. However, immunomodulators such as methotrexate, tacrolimus, azathioprine, cyclosporine and mycophenolate mofetil together with anti-tumor necrosis factor-α (anti-TNF alpha) monoclonal antibodies such as adalimumab and infliximab, may be required to control the inflammation and the associated ME in refractory cases, or when an underlying disease is present. This review of the literature will focus mostly on the non-infectious UME.

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Section: Etiology Of Non-infectious Umementioning

confidence: 99%

<p>Macular edema associated with non-infectious uveitis: pathophysiology, etiology, prevalence, impact and management challenges</p>

Massa

Pipis

Adewoyin

et al. 2019

OPTH

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“…1 Patients may complain of color vision abnormalities, visual field deficits, or nyctalopia. 2 In one series, birdshot represented 6% to 7.6% of posterior uveitis patients. 1 It is largely a disease of middle-and olderaged Caucasians, with a slight female predominance.…”

Section: Discussionmentioning

confidence: 95%

Advanced Birdshot Chorioretinopathy Presenting as Chronic Cystoid Macular Edema and Vitritis Following Cataract Surgery

Powers

Wood

Sanislo

et al. 2018

Journal of VitreoRetinal Diseases

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The purpose of this case report is to present a case of birdshot chorioretinopathy in an elderly woman who presented with postoperative macular edema and vitritis following cataract surgery. Methods: A retrospective case report was compiled of the use of optical coherence tomography, scanning laser ophthalmoscopy, fluorescein angiography, and wide-angle fundus photography to document exam findings. Results: An 81-year old woman presented with steroid-resistant bilateral cystoid macular edema and vitritis following cataract surgery. Clinical testing, including serum HLA-A29, was suggestive of birdshot chorioretinopathy. Pars plana vitrectomy with membrane peeling was performed, and the patient was started on both steroidsparing immunomodulatory therapy and systemic corticosteroids. Her macular edema improved and her disease progression stabilized. Conclusions: To the best of the authors' knowledge, this is the oldest patient diagnosed with birdshot chorioretinopathy to be reported in the literature. The unusual initial presentation following cataract extraction highlights the importance of diagnostic vigilance when facing an unusual case of posterior uveitis.

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“…Birdshot chorioretinitis is a bilateral posterior uveitis characterised by multiple hypopigmented choroidal lesions clustered around the optic nerve head 9 . It is typically seen in Caucasians in their fourth to sixth decade of life and affects females more than males 9, 10. Birdshot chorioretinitis has a strong genetic association with human leukocyte antigen A29, with up to 95% of patients testing positive for the marker.…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 8% of the general Caucasian population are also HLA-A29 positive but never develop birdshot chorioretinopathy. The development of the chorioretinitis is believed to be T-cell mediated, involving interleukin IL-7, but this hypothesis has yet to be fully confirmed 9 . Recent therapeutic trials of IL-7 inhibitors have yielded disappointing results 9, 10…”

Section: Discussionmentioning

confidence: 99%

NUT carcinoma of the sinonasal tract infiltrating the orbit in a man with birdshot chorioretinitis

Chan

Bullock

Samad

et al. 2018

Saudi Journal of Ophthalmology

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A 48-year-old man with a history of birdshot chorioretinitis presented with blurry vision, retro-bulbar pain and sinusitis. Though visual acuity was unaffected, he had left optic disc oedema and mild restriction of left eye abduction. His symptoms progressed quickly, with diplopia in primary gaze, epistaxis from his left nostril, and a left relative afferent pupillary defect (RAPD). On computed tomography, there was a mass in the nasal cavity that extended through the left cribriform plate and lamina papyracea and posteriorly into the optic canal. Pathological examination of biopsy specimens revealed sheets of undifferentiated cells with extensive areas of necrosis and islands of squamous differentiation. The tumour cells expressed monokeratin, p63, CD34, and p16. Molecular testing indicated rearrangement of the (15q14) locus and fusion of the and (19p13.12) loci, confirming the diagnosis of NUT carcinoma of the sinonasal tract. This is the first reported case of NUT carcinoma in a patient with birdshot chorioretinitis. The onset of chorioretinitis may have been the earliest sign of the effects of the BRD4-NUTM1 fusion protein, resulting in expression of HLA-A29. There is evidence that bromodomain and extra terminal (BET) family proteins play a role in inflammatory marker expression.

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Birdshot chorioretinopathy

Cited by 19 publications

References 51 publications

<p>Macular edema associated with non-infectious uveitis: pathophysiology, etiology, prevalence, impact and management challenges</p>

<p>Macular edema associated with non-infectious uveitis: pathophysiology, etiology, prevalence, impact and management challenges</p>

Advanced Birdshot Chorioretinopathy Presenting as Chronic Cystoid Macular Edema and Vitritis Following Cataract Surgery

NUT carcinoma of the sinonasal tract infiltrating the orbit in a man with birdshot chorioretinitis

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