Birdshot Chorioretinopathy (BSCR) Diagnostic Findings, Fundus Examination Characteristics, Genetic Predisposition (HLA-A29), Treatment Prognosis

👁 “Birdshot Chorioretinopathy (BSCR) – Cream-Colored Spots and Autoimmunity”

Birdshot Chorioretinopathy (BSCR) is a rare, bilateral posterior uveitis subtype that presents with multiple cream-colored choroidal lesions, radiating from the optic nerve in a “birdshot” pattern.
Most patients are middle-aged females, and the condition has a strong genetic association with HLA-A29.

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✅ Key Clinical Summary of BSCR

FeatureDescription

Typical Demographics	Women aged 40–60
Laterality	Always bilateral and symmetric
Genetic Association	>90% HLA-A29 positive
Fundus Findings	Cream-colored choroidal lesions, radially spreading from optic disc
Inflammation Pattern	Mild anterior, posterior vitreous haze prominent
Complications	Cystoid macular edema (CME), optic disc edema
FA Findings	Late hyperfluorescence, disc leakage
ICG Findings	Hypofluorescent spots in choroid (extensive and larger than FA)
Treatment	Oral or periocular steroids (PSTA), consider immunosuppressants for recurrent CME
Prognosis	Visual acuity can be preserved with proper CME control

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✅ Clinical Pearl:
Unlike other intermediate uveitis cases, BSCR lacks snowballs/snowbanks, but ICG hypofluorescent choroidal lesions + HLA-A29 positivity make it diagnosable.