Outer retinal disruption may accompany cases of birdshot chorioretinopathy

This study provides data that support outer retinal disruption (ORD) as an early manifestation in early-onset birdshot chorioretinopathy (BSCR), as seen on ocular imaging.

Study design

A multicenter, retrospective, longitudinal case series of 60 patients focused on 5 patients (10 eyes) who met the inclusion criteria of being newly diagnosed with birdshot chorioretinopathy (BSCR) and outer retinal disruption (ORD). The latter was defined as attenuation of either the external limiting membrane or the ellipsoid zone (EZ) / interdigitation zone, per OCT findings.

Outcomes

After treatment with local and/or systemic agents, 70% of eyes regained vision to 20/20. Outer retinal disruption corresponded to fundus autofluorescence patterns and hypofluorescent dots on late indocyanine green angiography, as well as retinal pigment epithelium and EZ disruption on OCT.

Limitations

This was a small retrospective case series with a relatively short follow-up period.

Clinical significance

When evaluating patients with uveitis who have ORD, it is important to keep BSCR in mind as a differential diagnosis. Multimodality imaging is useful in BSCR diagnosis and management.