Anti-VEGF Therapy for Choroidal Neovascularisation Secondary to Birdshot Chorioretinopathy

Background

Birdshot retinochoroidopathy is a rare disease affecting predominantly middle-aged Caucasians females. It is a chronic, recurrent, bilateral inflammatory disease of unknown aetiology, first described in 1949 by Babel and Francheschetti as ”Choriorétinite en tâche de bougie”. Ryan and Maumenee relabelled it as Birdshot retinochoroidopathy in 1980 [4]. This affection is clinically characterized by retinal vasculitis, white-yellowish round to oval choroidal lesions radiating from the optic disc to the equator. Cystoid macular edema leading to macular atrophy and permanent visual loss is the main complication observed in this affection, but more recently it has been recognised that widespread retinal involvement also tends to occur. These abnormalities can be easily documented by visual field test or electrodiagnostic tests and are now considered an indication for treatment even in the presence of normal central vision [4] [8] [10]. Choroidal neovascular membrane (CNV) represents a rare complication and has been reported in 6 % of cases [8]. It usually develops at the margin of areas of RPE damage juxtafoveally or subfoveally, and can also appear juxtapapillary. Neovascularisation of the retina, peripapillary or peripherally, has also been observed in BCR [4]. CNV left untreated can lead to central visual loss.

We describe a patient with BCR who suffered this complication and who was successfully treated with a short course of anti-VEGF therapy.

References

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