Visual Acuity in Birdshot Retinochoroidopathy Evaluation

Touhami, Sara; Fardeau, Christine; Vanier, Antoine; Knoeri, Juliette; Montcel, Sophie Tezenas du; Troumani, Y.; Bodaghi, Bahram; Hoang, P. Le

doi:10.1016/j.ajo.2015.07.008

Cited by 12 publications

(3 citation statements)

References 24 publications

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“…As in most uveitis trials, patients were considered to have treatment failure if they met any one of the criteria as mentioned in the methods and materials section. In BU, visual acuity is often preserved, 40 macular oedema often does not involve the centre of the macula and VH is not pronounced. Therefore, these criteria are not very reliable to determine treatment failure or to monitor disease.…”

Section: Discussionmentioning

confidence: 99%

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

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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.

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Section: Discussionmentioning

confidence: 99%

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

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“…There is more information in the literature concerning the abnormalities of the visual field, including peripheral constriction, generalized diminished sensitivity, enlarged blind spot, and central or paracentral scotoma. 34,35 Recent studies showed that MD might be stable 2 whereas PSD possibly reflecting sectorial changes increases, especially in patients who received short-term treatment. Pointwise linear regression analysis of luminance sensitivity can identify visual field loss despite a stable MD.…”

Section: Discussionmentioning

confidence: 99%

Five-Year Trends in Multifocal Electroretinogram for Patients With Birdshot Chorioretinopathy

Mailhac

Labarère

Aptel

et al. 2019

American Journal of Ophthalmology

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“…Disease course is generally monitored with changes in visual acuity over time, cellular reaction within the anterior chamber and vitreous, leakage of the retinal vasculature and the appearance of the hallmark birdshot lesions. Visual acuity alone has not been shown to significantly correlate with clinical inflammation and therefore does not fully reflect disease severity in birdshot chorioretinopathy [6]. Fluorescein angiography and indocyanine green angiography have been utilized to visualize the vascular architecture in these patients and monitor the extent of vascular leakage as a proxy for disease activity [7, 8].…”

Section: Introductionmentioning

confidence: 99%

Visual response and anatomical changes on sequential spectral-domain optical coherence tomography in birdshot chorioretinopathy treated with local corticosteroid therapy

et al. 2016

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BackgroundBirdshot chorioretinopathy is a chronic bilateral inflammatory disease of unknown etiology characterized by bilateral retinal vasculitis, mild to moderate vitritis, retinal vascular leakage, cystoid macular edema (CME), and typical “birdshot” chorioretinal lesions. Typically, patients with birdshot chorioretinopathy are treated with systemic immunosuppressive and/or corticosteroid therapy in an effort to minimize loss of vision. Spectral-domain OCT (SD-OCT) has shown regional or generalized photoreceptor loss in addition to both retinal as well as choroidal thinning in these patients. The present study describes anatomical changes of the retina and alterations in choroidal thickness and vasculature on sequential spectral-domain optical coherence tomography (SD-OCT) in 4 patients with birdshot chorioretinopathy treated with local corticosteroids.MethodsA retrospective observational case series identified 4 consecutive patients (8 eyes) at New England Eye Center, Boston diagnosed with birdshot chorioretinopathy according to the research criteria of the international consensus conference that were managed by a single retina specialist and treated exclusively with local corticosteroid therapy (intravitreal/sub-tenon injections) without systemic immunosuppression. All patients underwent longitudinal SD-OCT imaging with both the 512 × 128 cube scan and the 1-line raster protocol. A chart review was performed to review the visual response to treatment. Two independent observers analyzed sequential SD-OCT images for retinal parameters such as occurrence of CME at any time during the course of disease, presence of retinal thinning and presence of hyper-reflective foci within the retina, and choroidal parameters including its thickness and its vasculature.ResultsMean age of the patients at diagnosis was 47 years (26–60 years). Mean duration of follow-up was 96 months. All patients were HLA-A29 positive. Visual acuity remained stable in 75 % of eyes, 63 % eyes had central retinal thinning, 75 % eyes had hyper reflective foci within the retina and 75 % eyes had CME during follow-up. Mean total sub-foveal choroidal thickness of all 8 eyes at the time of the last SD-OCT was significantly lower than at initial SD-OCT (p = 0.03).ConclusionsThis case series suggests that treatment with local corticosteroids may have good visual outcome despite retinal and choroidal thinning. Future longitudinal studies are necessary to further determine the benefits of local corticosteroid therapy.

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Visual Acuity in Birdshot Retinochoroidopathy Evaluation

Cited by 12 publications

References 24 publications

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

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

Five-Year Trends in Multifocal Electroretinogram for Patients With Birdshot Chorioretinopathy

Visual response and anatomical changes on sequential spectral-domain optical coherence tomography in birdshot chorioretinopathy treated with local corticosteroid therapy

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