Gender differences in birdshot chorioretinopathy and the white dot syndromes: do they exist?

Abstract

Inflammatory conditions that affect the posterior pole are diverse. Specifically, birdshot chorioretinopathy and the white dot syndromes present with multiple white dots in the fundus. These diseases appear to affect similar age groups but there is question as to whether or not a difference exists between the genders. This review summarizes the current studies on birdshot chorioretinopathy and the white dot syndromes as they are related to gender, exploring the differences, if any, which may exist between prevalence, clinical presentation, and treatment response for these diseases. Though the specific etiology of these diseases remains unclear, future treatments may be guided as to how these diseases affect the sexes differently.

Figure 1

(a) Wide-field fundus photograph of a 34-year-old Caucasian male (diagnosed with BCR one year prior to presentation) with (b) corresponding fluorescein angiogram demonstrating vasculitis. (c) Magnified view of the classic lesions (blue circles) and (d) magnified view of vasculitis and late optic disc leakage. No prior treatment. (e) In contrast, bilateral fundus photography of a 55-year-old Caucasian woman diagnosed with BCR two years prior to presentation with more impressive lesions and vascular sheathing. No prior treatment.

Figure 2

(a) Fundus photograph and corresponding (b) midphase fluorescein angiogram showing blockage of some lesions and the beginning of staining of other lesions as the later phase begins in APMPPE.

Figure 3

(a) Fundus photograph and corresponding (b) fluorescein angiogram (FA) demonstrating classic wreath-like patterns in MEWDS. (c) Fundus photograph of the macula of different patient demonstration foveal granularity and (d) magnified view of the wreath-like patterns seen on FA in MEWDS.

Figure 4

(a) Fluorescein angiogram of a patient with MFC demonstrating concurrent macular edema. (b) Fundus photograph of a patient with MFC requiring systemic immunosuppression.

Figure 5

(a) Fundus photography and corresponding fluorescein angiogram ((b)–(d)) of a young woman with PIC demonstrating leakage consistent with a choroidal neovascular membrane.