Birdshot retinochoroiditis in Brazil: a multicenter review of 40 patients

Abstract

Background Birdshot retinochoroiditis (BRC) is a rare and chronic bilateral uveitis mostly found in Caucasians. As few data are available about the clinical course of BRC in Hispanic patients, we aimed to report the clinical findings and the evolution of BRC in Brazilian patients. Methods This retrospective cohort multicenter nationwide study was performed by analyzing the records of patients with BRC diagnoses from Brazilian ophthalmological centers from April 1995 to May 2020. Results Forty patients (80 eyes) with a diagnosis of BRC were evaluated. The mean age was 53 years, and there was no sex predominance. All tested patients (34/40) were positive for HLA-A29. The diagnosis of BRC was made following the Levinson et al. criteria, and all ancillary tests were performed to exclude differential diagnoses. Clinical signs and symptoms, such as complications and treatment, were described. Conclusions BRC evolution in Brazilian patients seems to have some peculiarities that diverge from the published literature available about Caucasians, as AS inflammation is higher in this population.

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

“…Contrary to what has been found by several recent study [ 27 , 28 ], we found a statistically significant improvement in BCVA before/after treatment, overall and in the two groups of interest. It should be noted, however, that although the mean initial BCVA did not differ between these two groups, there was a different distribution of patients between subgroups: our results suggest a greater visual improvement for patients with severely impaired initial BCVA (<20/40 Snellen, Log MAR 0.30) in the methylprednisolone group, supporting our practice of administering corticosteroids loading doses to these patients.…”

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

“…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).…”

“…In the methylprednisolone group, 13/28 (46.4%) patients were treated exclusively with intravenous cortisone with oral relay and 12/13 (92.3%) had reached inflammation control at their last assessment. At last check, 3/13 (23.1%) patients were weaned off cortisone; their mean (range) follow-up duration without treatment was 27.3 (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) months. Among these 13 patients, the mean (range) cortisone dose at the end of follow-up was 3.5 (0-9) mg/day.…”

“…A total of three patients in the cohort were considered in remission at the end of followup (two in the methylprednisolone group, one in the prednisone group), requiring no treatment for at least 18 months. Those patients were followed for a mean (range) duration of 25 (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) months without treatment and did not display any sign of relapse during this period. One patient from the methylprednisolone group relapsed after 18 months of monitoring without treatment.…”

“…The study was conducted in accordance with the Declaration of Helsinki, and received approval from the local ethics committee in February 2019 (No. [19][20][21][22][23][24][25][26][27][28][29][30][31].…”