Birdshot Choroidopathy

1. Birdshot Choroidopathy Birdshot Retinochoroidopathy is a posterior uveitis seen in women 30-60 years of age who present with floaters, changes in color vision, and difficulty with night vision. It is called birdshot after the appearance of pellets from a shot gun. Examination will show little anterior uveitis or inflammation, but cells in the vitrious, creamy colored spots throughout the fundus, macular edema, and occasionally disc edema will be present in both eyes. As the disease progresses, the fundus will become progressively and strikingly more like a “blonde” fundus, with little pigmentation. The ERG may show reduction of the B-wave and the EOG is also abnormal. Vision remains good unless there is significant cystoid macular edema. Treatment with steroids has sometimes been recommended. (A) Birdshot.Long-standing birdshot retinopathy in a woman with slight disc swelling.You can see the depigmentationin the retina and choroid especiallynasal to the disc. The arrows pointto a few of the depigmented areasof birdshot choroidopathy. (B) Birdshot Choroidopathy.Typical depigmentation of Birdshot retinopathy; the vasculature is somewhat attenuated.Photograph Courtesy of Paul Zimmerman, MD