Birdshot Chorioretinopathy: Resistant versus Responsive

Maleki, Arash; Look-Why, Sydney; Manhapra, Ambika; Asgari, Soheila; Garcia, Cristina M.; Al-Dabbagh, Alaa; Tsang, Catherine; Chang, Peter Y.; Anesi, Stephen D; Foster, C. Stephen

doi:10.1080/09273948.2022.2032193

Cited by 3 publications

(8 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although some studies have found IME as a poor prognostic factor in the context of BSCR [ 31 ], our data did not show a significant difference in inflammation control at the end of follow-up between patients with and without IME. Similarly, we did not find more relapses in this subgroup of interest compared to the entire cohort.…”

Section: Discussioncontrasting

confidence: 99%

“…Although steroid side effects are frequent, they are generally not serious and diminish with the treatment tapering to doses <7.5 mg/day [ 33 ]. Some clinical characteristics of the disease, such as IME, seem to require more a frequent use of IST, which is consistent with the data of Maleki et al [ 31 ]. In addition, some authors have already demonstrated the effectiveness of IST in preventing IME, in comparison with corticosteroid therapy [ 17 ].…”

Section: Discussionsupporting

confidence: 90%

“…Furthermore, nearly a fifth of patients were experiencing a relapse or had not reach control at the end of follow up. In our experience and as demonstrated in many studies [ 31 , 33 ], BSCR is a condition requiring prolonged treatment with a very slow tapering in corticosteroid therapy, sometimes with the long-term maintenance of a low dose of cortisone if well tolerated (>30 months according to Maleki et al [ 28 ]). As relapses occurred in nearly a third of patients per year, a delay of three months does not allow us to consider a patient in remission, thereby explaining the major difference in results between the study issued by Crowell et al and ours.…”

Section: Discussionmentioning

confidence: 82%

“…As stated in many studies [ 5 , 13 , 14 , 26 ], visual acuity only deteriorates late during the course of BSCR while visual blur and discomfort are frequent complaints of patients that considerably impair their quality of life [ 30 ]. Alterations of the BCVA are most often the consequence of an IME [ 14 , 26 ], which has itself recently been singled out as a possible factor of treatment resistance [ 31 ]. As almost 40% of patients from the methylprednisolone group had IME at inclusion, this may have contributed to limit visual recovery in this group, especially since about half of the patients with initial IME were uncontrolled or experienced relapsed by the end of follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…The study received approval from the local ethics committee in February 2019 (No. [19][20][21][22][23][24][25][26][27][28][29][30][31] and was registered on clinicaltrials.gov (NCT03877575).…”

Section: Methodsmentioning

confidence: 99%

See 4 more Smart Citations

Long-Term Outcomes of Birdshot Chorioretinopathy Treated with Corticosteroids: A Case Reports

Ferracci

Mathis

Gavoille

et al. 2023

JCM

View full text Add to dashboard Cite

Purpose: To report the progression of patients diagnosed with birdshot chorioretinopathy (BSCR) initially treated with corticosteroids. Methods: We included 39 BSCR patients that were followed for ≥1 year. We analyzed their progression under treatment after 1, 3, 6 months, 1 year, and at the end of follow-up. In order to determine the efficiency of initial loading doses, patients were classified into two groups according to their initial treatment: methylprednisolone followed by prednisone (n = 28) and prednisone alone (n = 11). Results: At the end of follow-up, 31/39 (79.5%) patients had reached inflammation control. Thirteen out of 28 (46.4%) and 6/11 (54.5%) patients were treated exclusively with corticosteroids, and 18/19 (94.7%) of them had reached inflammation control at the end of follow-up; their mean (range) corticosteroid dose was 3.5 (0–10) mg/day. Conclusions: We found that the prolonged corticosteroid therapy treatment strategy resulted in inflammation control in half of BSCR patients. This control was maintained with low doses of cortisone, usually <5 mg/day.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Long-Term Outcomes of Birdshot Chorioretinopathy Treated with Corticosteroids: A Case Reports

Ferracci

Mathis

Gavoille

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

Efficacy and safety of abatacept to treat active birdshot uveitis: a prospective open label interventional proof-of-concept trial

Schauwvlieghe

Calster

Herbort³

et al. 2022

Br J Ophthalmol

View full text Add to dashboard Cite

Background/aimsBirdshot uveitis (BU) is a chronic autoimmune posterior uveitis, mostly affecting middle-aged Caucasians. There is a strong association with HLA-A29 and T-cell activation. Safety and efficacy of abatacept, an inhibitor of T-cell costimulation, is tested in active BU.MethodsFifteen patients with active BU were treated with monotherapy of weekly subcutaneous injections of abatacept 125 mg/mL. Time-to-treatment failure was evaluated as a primary outcome. The secondary objective was to evaluate the utility of different outcome measures to monitor disease activity. Safety was evaluated by adverse event reporting and serial blood analyses.ResultsAt the year-1 endpoint, there was significant improvement in vitreous haze grade (p=0.0014), central choroidal thickness (CCT) (p=0.0011), Fluorescein Angiography (FA) Score (p=0.0014), Indocyanine Green Angiography (ICGA) Score (p<0.001) and total dual FA-ICGA Score (p<0.001). Best corrected visual acuity (BCVA) (p=0.8354) and central retinal thickness (CRT) (p=0.3549) did not change significantly. There were no serious adverse events reported. In total, 4 out of 15 patients left the trial during year 1 of whom 2 experienced treatment failure.ConclusionsAbatacept is very efficacious to treat both retinal vasculitis and choroiditis in patients with BU and is well tolerated. BCVA and CRT are inadequate to monitor disease activity. On the other hand, CCT is a promising non-invasive tool to detect treatment response in early active BU and dual FA-ICGA Score is very helpful to evaluate retinal vasculitis and choroiditis quantitatively.Trial registration numberNCT03871361.

show abstract

Long-term Outcomes of Birdshot Chorioretinopathy Treated With Corticosteroids: A Retrospective Cohort Study

Ferracci¹,

Mathis²,

Gavoille³

et al. 2023

Preprint

View full text Add to dashboard Cite

Purpose: To report the progression of patients diagnosed with birdshot chorioretinopathy (BSCR) initially treated with corticosteroids. Methods: We included 39 BSCR patients followed for ≥1 year. Patients were classified into 2 groups according to their initial treatment: methylprednisolone followed by prednisone (n=28) and prednisone alone (n=11). We analyzed the progression under treatment after 1, 3, 6 months, 1 year, and at the end of follow-up. Results: At the end of follow-up, 31/39 (79.5%) patients had reached inflammation control. Thirteen out of 28 (46.4%) and 6/11 (54.5%) patients were treated exclusively with corticosteroids, and 18/19 (94.7%) of them had reached inflammation control at the end of follow-up; their mean (range) corticosteroid dose was 3.5 (0-10) mg/day. Conclusion: We found that the prolonged corticosteroid therapy treatment strategy resulted in inflammation control in half of BSCR patients. This control was maintained with low doses of cortisone, usually <5 mg/day.

show abstract

Birdshot Chorioretinopathy: Resistant versus Responsive

Cited by 3 publications

References 25 publications

Long-Term Outcomes of Birdshot Chorioretinopathy Treated with Corticosteroids: A Case Reports

Long-Term Outcomes of Birdshot Chorioretinopathy Treated with Corticosteroids: A Case Reports

Efficacy and safety of abatacept to treat active birdshot uveitis: a prospective open label interventional proof-of-concept trial

Long-term Outcomes of Birdshot Chorioretinopathy Treated With Corticosteroids: A Retrospective Cohort Study

Contact Info

Product

Resources

About