Birdshot Chorioretinopathy
Introduction:
Birdshot retinochoroidopathy, also called vitiliginous chorioretinitis, is a rare bilateral posterior uveitis affecting usually healthy adults between the third to sixth decades of life with a female preponderance. An autoimmune pathogenesis has been suggested with reactivity to the retinal S antigen. There is a strong association with HLA-A29 (>90% of cases). HLA-B44 is also positive in many cases.
Clinical Features:
Decreased vision, photopsias, floaters, nyctalopia, and decreased color vision are frequent symptoms. There is minimal to no anterior uveitis with mild vitritis. Multifocal depigmented cream-colored retinal pigment epithelium lesions less than one disc diameter in size are scattered throughout the fundus, although these may be absent or very subtle in the early stages of the disease (Fig. 17.2.1). Retinal phlebitis, narrowing and sheathing of retinal vasculature, disc edema, optic atrophy, cystoid macular edema, choroidal neovascularization and epiretinal membrane may also develop.
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