Uveitis Service, Moorfields Eye Hospital, London, England 2Department of Ophthalmology, Royal Surrey County Hospital, Guildford, England 3Institute of Ophthalmology, University College of London, London, England.
Uveitis Service, Moorfields Eye Hospital, London, England 2Department of Ophthalmology, Royal Surrey County Hospital, Guildford, England 4Division of Immunology and Inflammation, Faculty of Medicine, Imperial College London, London, England.
JAMA Ophthalmol. 2014 Jan;132(1):57-62. doi: 10.1001/jamaophthalmol.2013.6235.
Birdshot chorioretinopathy is a chronic intraocular inflammatory disease with no uniform method to document long-term disease progression or response to treatment.
To examine the long-term visual, clinical, and anatomic outcomes of patients with birdshot chorioretinopathy.
DESIGN, SETTING, AND PARTICIPANTS: A retrospective evaluation of 46 patients with birdshot chorioretinopathy treated at Moorfields Eye Hospital, London, England, was conducted. Medical records for a 19-year period (1993-2012) were reviewed.
Patients received no treatment, short-term (≤1 year) treatment including local or systemic corticosteroids, or long-term (>1 year) treatment including systemic corticosteroids and second-line immunosuppressive agents.
Details regarding clinical and anatomic outcome, including best-corrected visual acuity, and visual field indices were evaluated.
Ninety-two eyes of 46 patients were monitored for a mean (SE) of 57.2 (5.8) months (445 eye-years, 17% follow-up of ≥10 years). Patients maintained a steady best-corrected visual acuity throughout the follow-up period. Some clinical indices correlated with transient worse best-corrected visual acuity, including presence of cataract (P = .05), foveal leakage on fluorescein angiography (P = .04), and increased central retinal thickness (P = .02). Serial visual field studies demonstrated that patients who received only short-term treatment had a worsening of their pattern standard deviation with time (Spearman correlation, 0.57; P = .003); for those who received long-term treatment, the pattern standard deviation remained stable (Spearman correlation, -0.24; P = .26).
Our results suggest that central visual acuity can be maintained long term in patients with birdshot chorioretinopathy. Those who receive long-term immunosuppression appear to maintain better peripheral visual fields compared with patients who receive short-term treatment.
鸟枪弹样脉络膜视网膜炎是一种慢性眼内炎症性疾病，目前尚无统一的方法来记录长期疾病进展或治疗反应。
检查鸟枪弹样脉络膜视网膜炎患者的长期视觉、临床和解剖结果。
设计、地点和参与者：对伦敦莫尔菲尔兹眼科医院 1993 年至 2012 年期间治疗的 46 名鸟枪弹样脉络膜视网膜炎患者进行了回顾性评估。对 19 年的病历记录进行了回顾。
患者接受了无治疗、短期（≤1 年）治疗（包括局部或全身皮质类固醇）或长期（>1 年）治疗（包括全身皮质类固醇和二线免疫抑制剂）。
评估了包括最佳矫正视力和视野指数在内的临床和解剖结果的详细信息。
46 名患者的 92 只眼平均（SE）监测 57.2（5.8）个月（445 眼年，17%的随访时间≥10 年）。患者在整个随访期间保持稳定的最佳矫正视力。一些临床指标与短暂的最佳矫正视力恶化相关，包括白内障的存在（P=0.05）、荧光素血管造影时的黄斑渗漏（P=0.04）和中央视网膜厚度增加（P=0.02）。连续的视野研究表明，仅接受短期治疗的患者随着时间的推移其模式标准差恶化（Spearman 相关性，0.57；P=0.003）；而接受长期治疗的患者模式标准差保持稳定（Spearman 相关性，-0.24；P=0.26）。
我们的研究结果表明，鸟枪弹样脉络膜视网膜炎患者的中心视力可以长期保持。与接受短期治疗的患者相比，接受长期免疫抑制治疗的患者似乎保持了更好的周边视野。
