Fundus autofluorescence shows RPE atrophy in birdshot chorioretinopathy

Fundus autofluorescence can demonstrate retinal pigment epithelial (RPE) atrophy in patients with birdshot chorioretinopathy, according to Hideki Koizumi, MD. RPE atrophy is difficult to visualize with other imaging techniques.

Dr. Koizumi and colleagues, from Kyoto Prefectural University of Medicine, Kyoto, Japan, conducted a study that included 16 eyes of eight Caucasian patients aged 35 to 73 years. The duration of the birdshot chorioretinopathy, which is characterized by hypopigmented spots on the choroid, in these patients ranged from 1 month to 19 years. The patients were evaluated using color and autofluorescence photography and optical coherence tomography.

Of the 16 eyes, 11 eyes of six patients had RPE atrophy as evidenced by hypoautofluorescent regions. Some of the hypoautofluorescent areas corresponded to the hypopigmented birdshot lesions, but the others did not necessarily correspond, which suggested that both the choroid and the RPE can be independently affected, he explained. Eight eyes (50%) of four 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 six eyes of three patients and was significantly correlated with a best-corrected visual acuity of 20/50 or less (p

"Monitoring the RPE atrophy with fundus autofluorescence may be important for the evaluation and management of birdshot chorioretinopathy," Dr. Koizumi concluded.