Thorne Jennifer E, Jabs Douglas A, Peters George B, Hair David, Dunn James P, Kempen John H
Department of Ophthalmology, the Johns Hopkins University School of Medicine, Baltimore, MD 21250, USA.
Am J Ophthalmol. 2005 Jul;140(1):45-51. doi: 10.1016/j.ajo.2005.01.035.
To describe the incidence of vision loss and of ocular complications attributable to birdshot retinochoroidopathy and to describe the association between therapy and the incidence thereof.
Retrospective cohort study.
Single-center, academic practice.
Forty patients with birdshot retinochoroidopathy were evaluated from January 1984 through March 2004.
Demographic and clinical information on patients diagnosed with birdshot retinochoroidopathy was collected.
Visual acuity and visual field loss; ocular complications including cystoid macular edema (CME).
In affected eyes, the frequencies of vision loss to 20/50 or worse and to 20/200 or worse and of CME at presentation were 33%, 13%, and 20%, respectively. Patients who presented with a duration of disease of > or = 30 months had higher frequencies of visual impairment to 20/50 or worse (68% vs 32%; P = .004) and to 20/200 or worse (32% vs 9%; P = .01), and had a higher frequency of CME (38% vs 14%; P = .02) than patients who presented with a duration of disease <30 months. The incidence rates on follow-up for vision loss to 20/50 or worse and to 20/200 or worse were 13% and 4% per eye-year (EY), respectively. The incidence of CME was 10%/EY. Use of immunosuppressive drug therapy was associated with a reduced risk of developing CME (relative risk = 0.17; 95% confidence interval: 0.05, 0.64; P = .009).
Birdshot retinochoroidopathy is a progressive disease with the potential for visual impairment. Patients who present at a later date after the onset of disease were more likely to have vision impairment and CME. Use of long-term immunosuppressive therapy may reduce the risk of CME.
描述鸟枪弹样视网膜脉络膜病变所致视力丧失和眼部并发症的发生率，并描述治疗与这些发生率之间的关联。
回顾性队列研究。
单中心学术机构。
1984年1月至2004年3月对40例鸟枪弹样视网膜脉络膜病变患者进行了评估。
收集被诊断为鸟枪弹样视网膜脉络膜病变患者的人口统计学和临床信息。
视力和视野丧失；眼部并发症，包括黄斑囊样水肿（CME）。
在受累眼中，就诊时视力下降至20/50或更差、20/200或更差以及CME的发生率分别为33%、13%和20%。疾病持续时间≥30个月的患者，视力下降至20/50或更差（68%对32%；P = 0.004）和20/200或更差（32%对9%；P = 0.01）的频率更高，CME的发生率也更高（38%对14%；P = 0.02），而疾病持续时间<30个月的患者则较低。随访期间视力下降至20/50或更差以及20/200或更差的发生率分别为每眼年（EY）13%和4%。CME的发生率为10%/EY。使用免疫抑制药物治疗与发生CME的风险降低相关（相对风险 = 0.17；95%置信区间：0.05，0.64；P = 0.009）。
鸟枪弹样视网膜脉络膜病变是一种具有视力损害潜力的进行性疾病。疾病发作后较晚就诊的患者更有可能出现视力损害和CME。长期使用免疫抑制治疗可能会降低CME的风险。
