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BIRDSHOT CHORIORETINITIS LESIONS ON INDOCYANINE GREEN ANGIOGRAPHY AS AN INDICATOR OF DISEASE ACTIVITY

Cao, Jennifer H. MD; Silpa-Archa, Sukhum MD; Freitas-Neto, Clovis A. MD; Foster, C. Stephen MD, FACS

doi: 10.1097/IAE.0000000000000967
Original Study
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Purpose: To determine whether classical indocyanine green angiography lesions in patients with birdshot chorioretinitis can be used to monitor disease activity.

Methods: A retrospective case series was performed on 26 eyes in 26 consecutive patients with birdshot chorioretinitis who had at least one indocyanine green angiography performed during disease activity and another during disease quiescence. Using Photoshop, the mean number, area, and area per spot on indocyanine green angiography were compared between disease activity and quiescence using a paired ratio test.

Results: The mean total lesion number, area, and area per spot during disease activity were 75.27 spots, 24,525 pixels, and 364 pixels/spots, respectively. The mean total lesion number, area, and area per spot size during disease quiescence were 28.35 spots (P < 0.01), 7,411 pixels (P < 0.01), and 279 pixels/spot (P = 0.12), respectively.

Conclusion: There was a statistically significant decrease in the mean total area and number of lesions between the time of disease activity and disease quiescence (P < 0.01). Our results suggest that indocyanine green angiography has a role not only in diagnosis but also in monitoring treatment effectiveness; lesions can be reversible with treatment and their reappearance may be an indicator of disease relapse.

The authors show, for the first time, that the number of birdshot lesions and the total lesion area decreases in most patients treated with immunosuppressive therapy, and return with a relapse. Therefore, these lesions can be used to monitor disease control.

*Massachusetts Eye Research and Surgery Institution (MERSI), Cambridge, Massachusetts;

Ocular Immunology and Uveitis Foundation, Cambridge, Massachusetts;

Department of Ophthalmology, Faculty of Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand; and

§Harvard Medical School, Cambridge, Massachusetts.

Reprint requests: C. Stephen Foster, MD, Massachusetts Eye Research and Surgery Institution, 1440 Main Street, #201, Waltham, MA 02451.

None of the authors have any financial/conflicting interests to disclose.

© 2016 by Ophthalmic Communications Society, Inc.