A 51-year-old female who presents to the uveitis clinic for evaluation of progressive vision loss of both eyes. Patient was referred after a complete infectious and non-infectious uveitis lab workup which was negative. Retinal vasculitis with abnormal choroidal filling pattern were detected on initial FA/ICG. As the clinical picture was suspected of birdshot choriortinopathy, HLA A29 was requested and reported positive.
She was treated with systemic steroid and immunosuppressive agents that controlled vitreous inflammation and retinal vasculitis initially. Patient wasn't compliant with systemic immunosuppressive treatment and was switched to local steroid treatment, first with subtenon triamcinolone and intravitreal dexamethasone implant injections and then intraocular fluocinolone implants. OCT angiography was able to monitor retinal vasculitis and response to treatment as well as fluorescein angiography. We detected structural retinal thickening secondary to inflammatory retinal vascular leakage on OCTA which may serve as a semi-quantitative alternative to FA to diagnose and monitor the response to treatment in patients with retinal vasculitis.
Presentation Date: 03/19/2020
Issue Date: 08/01/2020