Maurice F. Rabb » Vitiligenous Or Bird Shot Choroidopathy

This 53 year old lady was first evaluated on July 22, 1980, at which time there was numbness on the right side of the face which began in February, 1980 with pain around her right eye. Episodes of numbness extending into the right side of the body lasting up to two weeks occurred in March. She had a history of a sore on the lower lip which was now healing. She has visual symptoms primarily in the right eye with floaters and vertical lines which are irregular and some blurred vision of four weeks duration.

Eye examination demonstrated the visual acuity was 20/30 (-2) in the right eye and 20/20 in the left eye. The anterior segment demonstrated a mild flare and occasional cell in the anterior chamber bilaterally. The anterior vitreous showed a few cells in both eyes. The right ocular fundus demonstrated slightly depigmented oval spots in the fundus which extended beyond the posterior pole into the retinal mid periphery in all quadrants. The disc was slightly swollen in the right eye and the posterior vitreous demonstrated a mild to moderate number of cells. There was a pigmented lesion just superior temporal to the fovea in the right macula which appeared to be slightly elevated. A chorioretinal scar was noted inferiorly near the ora seratta, but no snowbank exudate was present. Cystoid macular edema was absent and there was no sheathing of the retinal blood vessels. Examination of the left vitreous and retina demonstrated identical pictures, except that there was no lesions in the left macula.

Ocular Diagnosis: vitiligenous or birdshot retinochoroidopathy, bilateral, weakly responsive to parenteral steroid therapy, with subretinal neovascularization, right macula.