Birdshot Chorioretinopathy in Early Adulthood: Review of Current Literature and Case Report

Abstract

Purpose

We describe the course of a patient diagnosed with birdshot chorioretinopathy (BSCR) in early adulthood and summarize clinical findings from similar BSCR patients reported in the literature.

Observations

A 37-year-old male presented to our tertiary uveitis facility with bilateral ocular discomfort, hazy vision, and floaters. Ocular examination was notable for vitritis, optic disc edema, and ovoid hypopigmented chorioretinal lesions, visible on indocyanine green chorioangiography as multiple hypocyanescent spots in the intermediate phase. Full-field electroretinography and visual evoked potential showed global retinal dysfunction and optic nerve dysfunction. Laboratory evaluations were notable only for human leukocyte antigen (HLA)-A29 positivity. The patient was diagnosed with BSCR and started on oral prednisone and eventually managed with infliximab.

Conclusions and Importance

BSCR can affect patients in early adulthood. Proper diagnostic work-up, including assessing HLA-A29 positivity, is needed to manage atypical cases.

Keywords:

• birdshot chorioretinopathy
• early adulthood
• human leukocyte antigen (HLA)-A29

Abbreviations

BSCR, Birdshot chorioretinopathy; CME, cystoid macular edema; ERM, epiretinal membrane; FA, fluorescein angiography; ffERG, full-field electroretinography; GVF, Goldmann visual fields; HLA, human leukocyte antigen; HVF, Humphrey visual fields; ICG, indocyanine green chorioangiography; IMT, immunomodulatory therapy; OD, right eye; OS, left eye; OU, both eyes; QFT, QuantiFERON-TB Gold; RPR, rapid plasma reagin; SD-OCT, Spectral domain optical coherence tomography; S-Ag, retinal soluble antigen.

Data Sharing Statement

The datasets used and/or analyzed in this study are available from the corresponding author upon reasonable request.

Consent for Publication

Informed consent to publish this case report has been obtained from the patient in writing. Institutional Board Review (IRB) approval was not required for the publication of this case report.

Acknowledgments

The authors acknowledge the medical providers at the Byers Eye Institute at Stanford for their contribution to the evaluation, diagnosis, and management of this patient.

Author Contributions

BHP and GU analyzed and interpreted the patient data. BHP wrote the manuscript with support from GU. All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Disclosure

Dr Quan Dong Nguyen reports grants from Acelyrin, Priovant, and Alumis, outside the submitted work. The authors report no other conflicts of interest in this work.

Additional information

Funding

There is no funding to report.