These creamy yellow-white choroidal lesions scattered throughout the posterior pole are characteristic of birdshot chorioretinopathy.
Learning Points:
This disease was appropriately described and named by Drs. Ryan and Maumenee (Am J Ophthalmol 1980;89:31-45), since the lesions look like shotgun birdshot scattered throughout the fundus.
Birdshot is typically chronic and bilateral, with a very high HLA-A29 association. It usually affects women in their 40s to 60s. Vision loss is usually caused by cystoid macular edema (CME) and retinal atrophy, although macular neovascularization can rarely occur.
Asymptomatic patients can be observed. CME and symptomatic uveitis can be treated with oral steroids, although many will still require immunomodulatory therapy.
