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. 2023 Aug 14;12(16):5288.
doi: 10.3390/jcm12165288.

Long-Term Outcomes of Birdshot Chorioretinopathy Treated with Corticosteroids: A Case Reports

Dino Ferracci  1 , Thibaud Mathis  1   2 , Antoine Gavoille  3 , Mathieu Gerfaud-Valentin  4 , Arthur Bert  4 , Meriem Hafidi  1 , Philippe Denis  1 , Olivier Loria  1   2 , Laurent Kodjikian  1   2 , Pascal Sève  4   5   6
Affiliations

Long-Term Outcomes of Birdshot Chorioretinopathy Treated with Corticosteroids: A Case Reports

Dino Ferracci et al. J Clin Med. .

Abstract

Purpose: To report the progression of patients diagnosed with birdshot chorioretinopathy (BSCR) initially treated with corticosteroids.

Methods: We included 39 BSCR patients that were followed for ≥1 year. We analyzed their progression under treatment after 1, 3, 6 months, 1 year, and at the end of follow-up. In order to determine the efficiency of initial loading doses, patients were classified into two groups according to their initial treatment: methylprednisolone followed by prednisone (n = 28) and prednisone alone (n = 11).

Results: At the end of follow-up, 31/39 (79.5%) patients had reached inflammation control. Thirteen out of 28 (46.4%) and 6/11 (54.5%) patients were treated exclusively with corticosteroids, and 18/19 (94.7%) of them had reached inflammation control at the end of follow-up; their mean (range) corticosteroid dose was 3.5 (0-10) mg/day.

Conclusions: We found that the prolonged corticosteroid therapy treatment strategy resulted in inflammation control in half of BSCR patients. This control was maintained with low doses of cortisone, usually <5 mg/day.

Keywords: birdshot chorioretinopathy (BSCR); corticosteroids; inflammatory macular edema; prognosis; relapse; uveitis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart. BCVA: best-corrected visual acuity. (*) Three patients were excluded because they did not meet the SUN diagnostic criteria [12], 23 because their follow-up duration was <1 year, or because of missing data, and two because their initial treatment was not a corticosteroid. (**) BCVA value at end of follow-up was not available for two eyes from the same patient, excluding those from the BCVA analysis. (***) One patient never achieved inflammation control in the methylprednisolone group, excluding him from various analysis including time to control, number of relapses, and time to relapse. (****) One patient had a single functional eye.
Figure 2
Figure 2
BCVA distribution among the studied groups and progression before/after treatment. BCVA: Best-corrected visual acuity. Median [IQR] BCVA before treatment in the methylprednisolone group: 0 [0–0.155]; Median [IQR] BCVA before treatment in the prednisone group: 0.0458 [0.0458–0.222]; Median [IQR] BCVA before treatment in the whole population: 0.0458 [0–0.155]; Median [IQR] BCVA after treatment in the methylprednisolone group: 0 [0–0]; Median [IQR] BCVA after treatment in the prednisone group: 0 [0–0]; Median [IQR] BCVA after treatment in the whole population: 0 [0–0].
Figure 3
Figure 3
Treatment regimen and changes during follow-up. *, ** Two patients of the methylprednisolone group did not undergo the one-year visit.
Figure 4
Figure 4
Cumulative incidence curves of inflammation control according to treatment group. Median [IQR] time to inflammation control (months) in the methylprednisolone group: 5 [2–10]; Median [IQR] time to inflammation control (months) in the prednisone group: 3 [3–5].
See this image and copyright information in PMC

References

    1. Jones N.P. The Manchester Uveitis Clinic: The first 3000 patients, 2: Uveitis Manifestations, Complications, Medical and Surgical Management. Ocul. Immunol. Inflamm. 2015;23:127–134. doi: 10.3109/09273948.2014.968671. - DOI - PubMed
    1. Gelfman S., Monnet D., Ligocki A.J., Tabary T., Moscati A., Bai X., Freudenberg J., Cooper B., Kosmicki J.A., Wolf S., et al. ERAP1, ERAP2, and Two Copies of HLA-Aw19 Alleles Increase the Risk for Birdshot Chorioretinopathy in HLA-A29 Carriers. Investig. Ophthalmol. Vis. Sci. 2021;62:3. doi: 10.1167/iovs.62.14.3. - DOI - PMC - PubMed
    1. Herbort C.P., Neri P., Papasavvas I. Clinicopathology of non-infectious choroiditis: Evolution of its appraisal during the last 2-3 decades from «white dot syndromes» to precise classification. J. Ophthalmic. Inflamm. Infect. 2021;11:43. doi: 10.1186/s12348-021-00274-y. - DOI - PMC - PubMed
    1. Touhami S., Fardeau C., Vanier A., Zambrowski O., Steinborn R., Simon C., Tezenas du Moncel S., Bodaghi B., Lehoang P. Birdshot Retinochoroidopathy: Prognostic Factors of Long-term Visual Outcome. Am. J. Ophthalmol. 2016;170:190–196. doi: 10.1016/j.ajo.2016.08.007. - DOI - PubMed
    1. Lages V., Skvortsova N., Jeannin B., Gasc A., Herbort C.P. Low-grade «benign» birdshot retinochoroiditis: Prevalence and characteristics. Int. Ophthalmol. 2019;39:2111–2120. doi: 10.1007/s10792-018-1050-8. - DOI - PubMed

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