Longitudinal cohort study of patients with birdshot chorioretinopathy. III. Macular imaging at baseline

PURPOSE: To describe optical coherence tomography (OCT) and fluorescein angiography (FA) parameters at baseline examination of 80 subjects (160 eyes) in a longitudinal cohort study of birdshot chorioretinopathy and to compare these parameters with measures of visual function and clinical findings. DESIGN: Single-center cross-sectional study. METHODS: Comparisons were made between OCT and FA parameters. The existence of relationships was examined between three OCT parameters (macular thickness, status of the third highly reflective band [HRB], epiretinal membrane) and the following factors: best,corrected visual acuity (BCVA), symptoms, color confusion score (CCS), vitreous haze, retinal vasculitis, and birdshot lesion characteristics. Grade of vascular leakage by FA was compared with the same factors. RESULTS: There was not good agreement between macular edema identified by OCT vs FA (kappa, 0.37). On multivariate analyses, decreased BCVA was related to abnormal macular thickness (P<.001), loss of the third HRB (P<.001), and vascular leakage (P=.034). When compared with macular parameters, symptoms were related most closely to loss of the third HRB. There were no strong relationships between birdshot lesion characteristics and macular parameters. CONCLUSIONS: Macular changes are reflected in reduced BCVA and may provide insight into mechanisms of some visual symptoms. Loss of the third HRB was the parameter most commonly related to other disease factors. Birdshot chorioretinopathy can result in macular thinning with central vision loss. FA and OCT each may be useful tests for the evaluation of the macula in patients with birdshot chorioretinopathy.