This article provides a straightforward overview of the causes, symptoms, diagnosis, treatment, and prevention strategies associated with birdshot chorioretinopathy.
The exact cause of birdshot chorioretinopathy is not fully understood, but it is believed to be an autoimmune condition in which the body's immune system mistakenly attacks cells in the retina and choroid. A person's genetic predisposition and environmental factors may also contribute to the development of the disease.
Symptoms of birdshot chorioretinopathy may include:
In the field of vision, floaters are small dark spots or specks.
Gradual or sudden blurring of vision.
Blind spots or areas of reduced vision are called scotomas.
In low-light conditions or at night, night blindness causes difficulty seeing.
Flashes of light or visual disturbances are called photopsias.
Eye redness, itching, or irritation.
In advanced stages of the disease, peripheral vision may be lost or tunnel vision may occur.
An ophthalmologist typically performs a comprehensive eye examination to diagnose birdshot chorioretinopathy.
Eye chart test for visual clarity.
In a slit-lamp examination, the front structures of the eye are examined under a specialized microscope.
Using a magnifying lens and bright light, fundoscopy examines the back of the eye, including the retina and choroid.
After injection of a fluorescent dye, fluorescein angiography allows visualization of the blood vessels in the retina and choroid.
In optical coherence tomography (OCT), cross-sectional images of the retina are produced and its thickness is measured.
An electroretinography (ERG) measures the electrical activity of the retina when it is stimulated by light.
As part of treatment for birdshot chorioretinopathy, inflammation is controlled, vision is preserved, and disease progression is prevented. Treatment options include:
The use of corticosteroids can reduce inflammation and suppress the immune system.
Medications that suppress the immune system and reduce inflammation include methotrexate, mycophenolate mofetil, and cyclosporine.
For refractory cases of birdshot chorioretinopathy, biologic agents such as adalimumab or infliximab may be recommended.
To reduce the need for long-term corticosteroid therapy, medications such as azathioprine or tacrolimus may be used as steroid-sparing agents.
For severe inflammation or macular edema, intravitreal injections of corticosteroids or anti-inflammatory agents may be considered.
Photocoagulation Therapy: Laser treatment can be used to seal leaky blood vessels or to treat abnormal retinal blood vessels (neovascularization).
The use of low-vision aids, such as magnifying lenses and telescopic glasses, can improve visual function for those with permanent vision loss.
Despite its autoimmune nature and unclear etiology, birdshot chorioretinopathy is challenging to prevent. Early detection and prompt treatment are crucial to preserving vision and preventing complications. A family history of birdshot chorioretinopathy or individuals at risk of developing it should be monitored by an ophthalmologist on a regular basis. The risk of developing ocular manifestations of the disease may also be reduced by maintaining overall health and managing systemic autoimmune conditions.
The birdshot chorioretinopathy is an autoimmune condition that affects the eyes, causing inflammation and damage to the retina and choroid. Managing the disease, preserving vision, and preventing complications requires early diagnosis and appropriate treatment. Although prevention is not possible, regular eye exams and monitoring can aid in detecting the disease early and maximizing outcomes for those affected.
