title: Long-term clinical and anatomic outcome of birdshot chorioretinopathy.
abstract: OBJECTIVE
  Birdshot chorioretinopathy is a chronic intraocular inflammatory disease with no uniform method to document long-term disease progression or response to treatment.
  
  
  OBJECTIVE
  To examine the long-term visual, clinical, and anatomic outcomes of patients with birdshot chorioretinopathy.
  
  
  METHODS
  A retrospective evaluation of 46 patients with birdshot chorioretinopathy treated at Moorfields Eye Hospital, London, England, was conducted. Medical records for a 19-year period (1993-2012) were reviewed.
  
  
  METHODS
  Patients received no treatment, short-term (≤1 year) treatment including local or systemic corticosteroids, or long-term (>1 year) treatment including systemic corticosteroids and second-line immunosuppressive agents.
  
  
  METHODS
  Details regarding clinical and anatomic outcome, including best-corrected visual acuity, and visual field indices were evaluated.
  
  
  RESULTS
  Ninety-two eyes of 46 patients were monitored for a mean (SE) of 57.2 (5.8) months (445 eye-years, 17% follow-up of ≥10 years). Patients maintained a steady best-corrected visual acuity throughout the follow-up period. Some clinical indices correlated with transient worse best-corrected visual acuity, including presence of cataract (P = .05), foveal leakage on fluorescein angiography (P = .04), and increased central retinal thickness (P = .02). Serial visual field studies demonstrated that patients who received only short-term treatment had a worsening of their pattern standard deviation with time (Spearman correlation, 0.57; P = .003); for those who received long-term treatment, the pattern standard deviation remained stable (Spearman correlation, -0.24; P = .26).
  
  
  CONCLUSIONS
  Our results suggest that central visual acuity can be maintained long term in patients with birdshot chorioretinopathy. Those who receive long-term immunosuppression appear to maintain better peripheral visual fields compared with patients who receive short-term treatment.
authors: Uveitis Service, Moorfields Eye Hospital, London, England 2Department of Ophthalmology, Royal Surrey County Hospital, Guildford, England 3Institute of Ophthalmology, University College of London, London, England.
authors: Oren
authors: O
authors: Tomkins-Netzer
authors: Uveitis Service, Moorfields Eye Hospital, London, England 2Department of Ophthalmology, Royal Surrey County Hospital, Guildford, England 4Division of Immunology and Inflammation, Faculty of Medicine, Imperial College London, London, England.
authors: Simon R J
authors: SR
authors: Taylor
authors: Uveitis Service, Moorfields Eye Hospital, London, England 2Department of Ophthalmology, Royal Surrey County Hospital, Guildford, England 3Institute of Ophthalmology, University College of London, London, England.
authors: Sue
authors: S
authors: Lightman
mesh_terms: D000080365:Birdshot Chorioretinopathy; D002825:Chorioretinitis / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use*; D015234:HLA-A Antigens / Q000097:blood; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D014794:Visual Fields / Q000502:physiology*
chemical_list: D005938:Glucocorticoids; D015234:HLA-A Antigens; C035524:HLA-A29 antigen; D007166:Immunosuppressive Agents