title: Birdshot chorioretinopathy.
abstract: OBJECTIVE
  Birdshot chorioretinopathy remains incompletely understood, but new insights into its pathogenesis have been reported recently, and treatment and monitoring options have also expanded. Central visual acuity may remain good until the late stages of the disease, but loss of visual field and peripheral retinal function is common.
  
  
  RESULTS
  The underlying pathogenesis of the disease has long been believed to be T-cell driven, but examination of the IL-17 pathway has now further refined the potential underlying mechanism. New imaging techniques, including extended depth imaging of the choroid with optical coherence tomography, have demonstrated promise in detecting disease activity earlier, enabling targeted treatment to be given. Treatment options have expanded with the advent of the biological agents, and these may yet improve outcomes, particularly in refractory patients.
  
  
  CONCLUSIONS
  Laboratory research continues to investigate the underlying mechanisms of disease, but our understanding remains frustratingly incomplete for a disease with such a clear HLA association. Clinical research is increasingly being driven to improve the phenotyping of affected patients so that those at risk of visual loss can be identified early and treated more aggressively with individually targeted therapies such as the newer biological agents, but how successful this approach will ultimately prove to be remains to be seen.
authors.affiliation: aFaculty of Medicine, Imperial College London, Hammersmith Hospital, London bRoyal Surrey County Hospital NHS Foundation Trust, Guildford, UK cInstitut Catala de Retina, Barcelona dDepartment of Ophthalmology, Provincial Hospital Consortium Castellon, Castello, Spain.
authors.forename: Emily H
authors.initials: EH
authors.lastname: Shao
authors.forename: Victor
authors.initials: V
authors.lastname: Menezo
authors.forename: Simon R J
authors.initials: SR
authors.lastname: Taylor
mesh_terms: D000080365:Birdshot Chorioretinopathy; D002825:Chorioretinitis / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D005451:Fluorescein Angiography; D006801:Humans; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology