Birdshot Retinochoroidopathy: Prognostic Factors of Long-term Visual Outcome

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• 作者：Sara Touhami^a ; ^{saratouhami@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Christine Fardeau^a ; Antoine Vanier^b ; Olivia Zambrowski^c ; Rafaela Steinborn^a ; Claude Simon^a ; Sophie Tezenas du Montcel^b ; ^d ; Bahram Bodaghi^a ; Phuc Lehoang^a
• 刊名：American Journal of Ophthalmology
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：170
• 期：Complete
• 页码：190-196
• 全文大小：164 K

文摘

To determine the prognostic factors of long-term visual outcome in birdshot retinochoroidopathy (BRC).

Methods

Design: Retrospective case series. Study Population: Successive HLA-A29+ BRC patients whose latest visit was between May and August 2013 at a single tertiary center (Pitié-Salpétrière Hospital, Paris). Observation Procedure: Endpoint visual status (remission or deterioration) was determined for each patient based on clinical and ancillary data from the latest visit including optical coherence tomography (OCT), automated visual field (AVF), and angiograms. Main Outcome Measure: Epidemiologic, clinical, OCT, AVF, angiographic, and electrophysiological data at baseline were correlated to final visual status.

Results

Fifty-five patients were included. Mean observation period was 8 years (range: 0.6-23 years). Mean disease duration was 9.8 years (range: 1.2-32.7 years). Female-to-male sex ratio was 1.6:1. Factors of good visual prognosis (remission vs deterioration) included at baseline: late age of disease onset (49.5 vs 45 years, P = .05), presence of vitreous inflammatory reactions >2+ (35.9% vs 6.2%, P = .04), vascular leakage on fluorescein angiograms (FA) (44.4% vs 12.5%, P = .03), absence of macular pigment epithelium atrophy on FA (88.9% vs 62.5%, P = .05), and presence of macular edema on OCT (33.3% vs 6.2%, P = .04). Preserved electrooculography light peak and Arden ratio (P = .06) and presence of choroidal spots on infracyanine green angiograms (80.0% vs 53.3%, P = .08) seemed associated with the best prognoses.

Conclusion

This study suggests a series of prognostic factors of long-term visual outcome in BRC. Keeping in mind the insidious evolution of the disease, knowledge of such prognostic factors should help tailor the treatment and monitoring of birdshot patients.