Maurice F. Rabb » Birdshot Chorioretinopathy

A 56 year old white male who presented in April 1972 with spots in front of both eyes.

There was no prior history of ocular disease, surgery or trauma. Family and social history were unremarkable.

Examination at that time revealed best corrected visual acuity of 20/25 O.D. and 20/20 O.S. Anterior segment examination was unremarkable. There was diffuse vitreous cellular reaction with dilated veins and scattered microaneurysms. There was mild elevation of both optic nerves and focal areas of choroiditis.

Fluorescein angiogram in April 1972 showed diffuse retinal vascular leakage a well as lekage from the optic nerves.

In October 1972, visual acuity was unchanged and the clinical exam remained unchanged. He was advised to be treated with topical, periocular and systemic steroids. There was occational fluctuation in vision following this treatment.

In March 1976, a consultant (Dr. Know) noted visual acuity of 20/40 O.U. with mild PSC's and "bird spots" in the fundus. Fluorescein angiography revealed retinal vascular leakage with cystoid macular edema.

In December 1976, another consultant (Dr. Carr) noted visual acuity of 20/40 O.D. and 20/200 O.S. He found evidence of generalized retinal dysfunction on the basis of a diffusely abnormal ERG.

In June 1981, an ERG revealed no photopic and a very small scotopic response.

In September 1982, he was again seen by us with visual acuity of 20/40 O.D. and 20/50 O.S. Anterior segment was unremarkable except for evidence of mild PSC's. Some areas of absolute scotomas were noted on Amsler grid. Multiple depigmented spots were seen in the fundus.

Fluorescein angiography showed diffuse leakage from all the retinal vessels with marked perifoveal capillary dilation and late cystoid macular edema. The depigmented spots seen clinically appeared as areas of window defect.