Evaluation of Corticosteroids, Immunosuppressants and Biotherapies in Patients with Birdshot Retinochoroidopathy.

OBJECTIVE

To evaluate the therapeutic response to corticosteroids (CS), conventional immunosuppressants (IS) and biotherapies in patients with birdshot retinochoroidopathy (BSCR).

METHODS

retrospective observational monocentric cohort study of 44 patients (87 eyes) with BSCR. We evaluated the therapeutic response between 4 and 12 months for venous vasculitis, capillary leakage, choroiditis and macular edema for the different therapeutic lines in each treated eye, a total of 225 evaluations. We defined responses as complete, partial, absent or quiescent according to a global inflammation score and according to the different inflammatory targets.

RESULTS

Corticosteroids showed significant efficacy in choroiditis and vasculitis with 70% and 63% complete responses in these two criteria respectively, whereas their efficacy in capillary leakage was less evident with 38% lack of response. Conventional IS achieved a complete response in 54% of cases of choroiditis and 48% of cases of vasculitis, while their efficacy was less evident in macular edema, with partial or no response in 60% of cases. Anti-TNFα are fully effective in 41% of cases of choroiditis and in 50% of cases of venous vasculitis. Their efficacy in macular edema was very modest, with 77% of trials showing partial or no response. Anti-IL-6 drug was particularly effective in macular edema with complete resolution in 100% of cases, whereas in choroiditis there was no response in 100% of cases.

CONCLUSION

CS, IS and anti-TNF-α drugs were effective to varying degrees for all inflammatory targets, whereas TCZ was ineffective for choroiditis and moderately effective for retinal vasculitis.