The patient presented with blurry vision, flashes of lights and floaters in the right eye that progressively worsened and eventually affecting her fellow eye. She was found to have signs of inflammation on clinical examination, which was further supported by imaging modalities showing retinal vasculitis, disc edema and diffuse choroidal lesions, consistent with birdshot chorioretinopathy (BCR). Laboratory testing was positive for HLA-A29. BCR is a rare chronic bilateral uveitis characterized by multiple irregular cream colored choroidal lesions with a strong association with HLA-A29. Diagnosis requires involvement of both eyes, 3 or greater birdshot lesions, and signs of vitreous haze and cell, although characteristic findings on ICG/FA and OCT along with an HLA-A29 serotype is highly supportive. Treatment typically begins with a course of steroids to control inflammation along with long term immunotherapy. Although BCR pathophysiology is poorly understood, there are many new studies investigating disease physiology, diagnostic modalities, and treatment.
Presentation Date: 09/02/2021
Issue Date: 09/24/2021