Advanced Birdshot Chorioretinopathy Presenting as Chronic Cystoid Macular Edema and Vitritis Following Cataract Surgery

Abstract

Purpose: The purpose of this case report is to present a case of birdshot chorioretinopathy in an elderly woman who presented with postoperative macular edema and vitritis following cataract surgery. Methods: A retrospective case report was compiled of the use of optical coherence tomography, scanning laser ophthalmoscopy, fluorescein angiography, and wide-angle fundus photography to document exam findings. Results: An 81-year old woman presented with steroid-resistant bilateral cystoid macular edema and vitritis following cataract surgery. Clinical testing, including serum HLA-A29, was suggestive of birdshot chorioretinopathy. Pars plana vitrectomy with membrane peeling was performed, and the patient was started on both steroid-sparing immunomodulatory therapy and systemic corticosteroids. Her macular edema improved and her disease progression stabilized. Conclusions: To the best of the authors’ knowledge, this is the oldest patient diagnosed with birdshot chorioretinopathy to be reported in the literature. The unusual initial presentation following cataract extraction highlights the importance of diagnostic vigilance when facing an unusual case of posterior uveitis.