Retina Vitreous Associates of Florida

Birdshot chorioretinopathy (sometimes called Birdshot retinochoroidopathy) is a rare retinal disorder characterized by multiple white spots in the retina and usually mild vision loss. Onset of vision problems is usually around age 50.

Birdshot Phoots

Above photos are of an HLA-A29 positive patient with bilateral birdshot chorioretinopathy.

Most patients present with blurred vision either from floaters or from macular swelling (cystoid macular edema). Ophthalmic examination usually reveals symmetrical white, creamy, depigmented spots

Some patients develop vision loss from vitreous hemorrhage, cataract, or subretinal neovascularization. Treatments for these disorders are usually effective at improving vision.

Prognosis is good in eyes that do not develop chronic cystoid macular edema. With modern treatments, most patients with Birdshot Chorioretinopathy can maintain good visual acuity.

This inflammatory disease is strongly associated with HLA-A29 suggesting a genetic and auto-immune cause. Patients who are HLA-A29 positive have over a 200 fold risk of developing Birdshot. This is the strongest relationships between HLA typing and any disease. HLA-A29 testing is 96% sensitive and 93% specific for Birdshot. A patients with a typical clinical presentation who is not HLA-A29 positive has only an 8.5% chance of having Birdshot.

The cause of the depigmented spots is unknown. They look like areas where there may have been previous inflammation. Some experts believe that these are depigmented areas from loss of melanin similar to what happens in the skin of people with vitiligo.

Fundus photography and fluorescein angiography are helpful in diagnosing and following patients with Birdshot Chorioretinopathy.

Pars Planitis
Intraocular Lymphoma
Syphilitic Chorioretinitis
Multiple Evanescent White Dot Syndrome
Multifocal Choroiditis
Sarcoidosis
Acute Multifocal Plaquoid Pigment Epitheliopathy
Punctate Inner Choroidopathy
Sympathetic Ophthalmia

Anti-inflammatory medications usually control the inflammation in patients with Birdshot and improve visual acuity in eyes with vision loss from macular swelling or floaters. Corticosteroids, either locally or orally, are usually effective. In more severe cases, where long term therapy may become necessary, treatment with cyclosporin, azathioprin and cyclophosphamide may be considered.





		Birdshot Chorioretinopathy Overview Etiology Differential Diagnosis Therapy Birdshot chorioretinopathy (sometimes called Birdshot retinochoroidopathy) is a rare retinal disorder characterized by multiple white spots in the retina and usually mild vision loss. Onset of vision problems is usually around age 50. Above photos are of an HLA-A29 positive patient with bilateral birdshot chorioretinopathy. Most patients present with blurred vision either from floaters or from macular swelling (cystoid macular edema). Ophthalmic examination usually reveals symmetrical white, creamy, depigmented spots Some patients develop vision loss from vitreous hemorrhage, cataract, or subretinal neovascularization. Treatments for these disorders are usually effective at improving vision. Prognosis is good in eyes that do not develop chronic cystoid macular edema. With modern treatments, most patients with Birdshot Chorioretinopathy can maintain good visual acuity. This inflammatory disease is strongly associated with HLA-A29 suggesting a genetic and auto-immune cause. Patients who are HLA-A29 positive have over a 200 fold risk of developing Birdshot. This is the strongest relationships between HLA typing and any disease. HLA-A29 testing is 96% sensitive and 93% specific for Birdshot. A patients with a typical clinical presentation who is not HLA-A29 positive has only an 8.5% chance of having Birdshot. The cause of the depigmented spots is unknown. They look like areas where there may have been previous inflammation. Some experts believe that these are depigmented areas from loss of melanin similar to what happens in the skin of people with vitiligo. Fundus photography and fluorescein angiography are helpful in diagnosing and following patients with Birdshot Chorioretinopathy. Pars Planitis Intraocular Lymphoma Syphilitic Chorioretinitis Multiple Evanescent White Dot Syndrome Multifocal Choroiditis Sarcoidosis Acute Multifocal Plaquoid Pigment Epitheliopathy Punctate Inner Choroidopathy Sympathetic Ophthalmia Anti-inflammatory medications usually control the inflammation in patients with Birdshot and improve visual acuity in eyes with vision loss from macular swelling or floaters. Corticosteroids, either locally or orally, are usually effective. In more severe cases, where long term therapy may become necessary, treatment with cyclosporin, azathioprin and cyclophosphamide may be considered.