Fundus autofluorescence in birdshot chorioretinopathy.

Purpose: To investigate the characteristics of fundus autofluorescence in birdshot chorioretinopathy (BSCR).

Design: Retrospective, observational case series.

Participants: Sixteen eyes of 8 consecutive patients with BSCR (3 men, 5 women).

Methods: Color and autofluorescence photography and optical coherence tomograms of patients with BSCR seen in a referral practice were evaluated.

Main Outcome Measures: Autofluorescent characteristics in BSCR.

Results: The 8 patients ranged in age from 35 to 73 years (mean, 56.9 years). Of the 16 eyes, 11 eyes (69%) of 6 patients had retinal pigment epithelium (RPE) atrophy as evidenced by hypoautofluorescent regions. Some of the hypoautofluorescent areas corresponded to the hypopigmented birdshot lesions, but the others did not necessarily show a correspondence. Eight eyes (50%) of 4 patients showed linear hypoautofluorescent streaks along the retinal vessels, most of which corresponded to visible changes at the level of the RPE. Placoid hypoautofluorescence in the macula was seen in 6 eyes (38%) of 3 patients and was correlated significantly with best-corrected visual acuity of 20/50 or less (P<0.05).

Conclusions: Autofluorescence photography demonstrated the RPE atrophy, which was hard to see by other means of investigation. The areas of RPE atrophy did not necessarily correspond to the hypopigmented lesions, which suggested that both the choroid and the RPE can be affected independently. Retinal pigment epithelium atrophy in the macula may be an important cause of poor central visual acuity in eyes with BSCR.