Birdshot's Chorioretinopathy in a Young Patient with a Good Response to the Combination of Corticosteroids and Cyclophosphamide

Abstract

Birdshot's chorioretinopathy is a well-known form of posterior uveitis, often chronic, bilateral and of unknown etiology. Its prevalence varies between 0.69 and 1.73 cases per 100,000 population. It is characterized by multiple, distinctive, hypopigmented choroidal lesions, and is strongly associated with human leukocyte antigen (HLA)-A29. The mean age at presentation is 53 years, with a slight female predominance (54.1%). It is a slowly progressive disease accompanied by profound visual dysfunction that may not be reflected by visual acuity unless associated macular edema is present. We report the case of a young 21-year-old patient who presented for an etiological work-up of bilateral ocular involvement with profound visual acuity impairment probably complicating macular edema, and in whom the diagnosis of Birdshot chorioretinopathy was retained with HLA A29 positive after exclusion of other etiologies of posterior uveitis and who responded well to a combination of corticosteroid boluses and cyclophosphamides relayed by azathioprine. The incidence of Birdshot chorioretinopathy in young is rare so this article throws light to consider birdshot chorioretinopathy as cause of posterior uveitis in young; as well as the efficacy of the combination of corticosteroids and cyclophosphamides in this pathology whose treatment is not consensual.