Birdshot chorioretinitis

Birdshot chorioretinitis is an uncommon cause of chronic, bilateral, posterior uveitis that typically occurs in middle-aged women. It is characterised by multiple patches of depigmentation of the choroid and retinal pigment epithelium. Its alternative name, vitiliginous chorioretinitis, reflects its resemblance to the skin condition, vitiligo.

Although the pathogenesis of birdshot chorioretinitis is unknown, immunological evidence suggests a role for genetic predisposition and retinal autoimmunity. The great majority of patients express the HLA-A29 antigen, and around half demonstrate immunological sensitivity to purified retinal S-antigen. Well described responses to immunosuppressive therapy have been consistent with these findings.