title: Indocyanine green angiography (ICGA) is essential for the early diagnosis of birdshot chorioretinopathy.
abstract: BACKGROUND
  Birdshot chorioretinitis (BC) is a rare disease involving the retina and the choroid independently. The hallmark for BC is the presence of depigmented oval lesion of the choroid, the so called "birdshot lesions", however in the early phase of disease these lesions are often not visible.
  
  
  METHODS
  A retrospective analysis of BC patients that were investigated in Centre for Ophthalmic Specialised Care, Lausanne, Switzerland between 1995 and 2010 was performed. Patients seen in the initial phase of BC disease devoid of a specific diagnosis when referred were included. Clinical investigations along with fluorescein angiography (FA), indocyanine green angiography (ICGA) and visual field testing (VF) were analysed.
  
  
  RESULTS
  Three out of 7 patients (43 %) seen in the initial phase of the disease devoid of a diagnosis at presentation were analysed. These patients presented with no "birdshot" lesions whatsoever. All three patients were HLA-A29 positive, presented with vitreitis and retinal vasculitis on FA. On ICGA, all 3 patients presented bilateral evenly distributed choroidal hypofluorescent dark dots (HDD) representing choroidal granulomas.
  
  
  CONCLUSIONS
  ICGA, by providing occult information on the choroid, is an essential tool for early diagnosis of BC. Because ICGA is still not universally practiced in uveitis centres early disease is often missed, its diagnosis delayed and proper treatment started late.
authors.affiliation: Inflammatory and Retinal Eye Diseases, Centre for Ophthalmic Specialised Care, Lausanne, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Papadia
authors.forename: C P
authors.initials: CP
authors.lastname: Herbort
mesh_terms: D000328:Adult; D000080365:Birdshot Chorioretinopathy; D002825:Chorioretinitis / Q000473:pathology*; D003287:Contrast Media; D042241:Early Diagnosis; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D005456:Fluorescent Dyes; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D005456:Fluorescent Dyes; D007208:Indocyanine Green