Photo Credit: Nepomuceno

The following is a summary of “Peripapillary atrophy in patients with birdshot chorioretinitis,” published in the February 2025 issue of British Journal of Ophthalmology by Moura et al. 

Researchers conducted a retrospective study to examine the frequency, extent, and association of peripapillary atrophy (PPA)with visual function in patients with birdshot chorioretinitis (BSCR).  

They assessed patients with BSCR. The optic nerve head (ONH) and PPA areas were measured using red-green and autofluorescence fundus images from ultrawidefield retinal photography. The primary outcome was PPA frequency. Correlations between the PPA/ONH ratio and factors such as disease duration, age, best corrected visual acuity (BCVA), and visual field parameters—mean deviation (MD) and pattern SD (PSD) from Humphrey perimeter 30–2—were analyzed using the Spearman coefficient.  

The results showed that 752 eyes from 384 patients (mean age 62.4±12.1 years) were analyzed, with a median disease duration of 13.0 (7.0–19.0) years. The PPA was detected in 717 eyes (95.4%). The mean PPA/ONH ratio was 2.9±2.2 on red-green images and 3.1±2.2 on autofluorescence, showing a strong correlation (R=0.95, P <0.0001). The PPA/ONH ratio increased with disease duration (R=0.57, P <0.0001), ranging from 1.6±0.6 to 5.2±2.9 after 25 years, and with age (R=0.51, P <0.0001). Higher PPA was linked to worse BCVA (R=−0.42, P <0.0001) and poorer visual field outcomes: MD (R=−0.41, P <0.0001) and PSD (R=0.42, P <0.0001). A robust intereye symmetry of the PPA/ONH ratio (R=0.91, P <0.0001) was noted, surpassing that of BCVA (R=0.58, P <0.0001), MD (R=0.76, P <0.0001), and PSD (R=0.70, P <0.0001).  

Investigators concluded that PPA was consistently present in patients with BSCR, progressed over time, and correlated with diminished visual acuity. 

Source:bjo.bmj.com/content/early/2025/02/26/bjo-2024-326440