Birdshot retinochoroidopathy in the absence of typical chorioretinal lesions

Abstract

Birdshot retinochoroidopathy is an ocular inflammatory disease characterized by depigmented lesions radiating from the optic disc. It may, however, present with isolated optic disc edema, vitritis, or vasculitis. ICG can play a critical role in diagnosising BSRC in cases where characteristic fundus lesions are subtle or absent. We describe a case of Birdshot retinochoroidopathy (BSRC) that presented with isolated optic nerve swelling. Neuroimaging and serum testing for infectious or inflammatory etiologies were unremarkable. Indocyanine angiography (ICG) revealed multiple round dark fundus lesions in both eyes. This raised suspicion for BSRC, which was confirmed with genetic testing. Ocular inflammation resolved following treatment with mycophenolate mofetil (MMF) and a dexamethasone intravitreal implant (Ozurdex®; Allergan Inc, Irvine, CA).

Keywords

• : Birdshot Chorioretinopathy
• Uveitis
• Indocyanine angiography
• HLA A29
• ICG