Atypical end-stage birdshot retinochoroidopathy

Purpose: To describe a patient with birdshot retinochoroidopathy with peripheral pigmentary changes mimicking a pseudoretinitis pigmentosa fundus. Case report: A 60-year-old female patient was referred for bilateral uveitis. Fundus examination showed several creamy lesions in the choroid of both eyes. The patient was HLA-A29-positive. A diagnosis of birdshot choroidopathy was made and she was treated with immunosupressive agents. Six years later, a pigmentation of the retina was noted in both eyes, which progressed to a bone-shaped appearance. Discussion: Pigmentary reaction is a common feature of retinal lesions, although it rarely takes on a retinitis pigmentosa-like appearance. Furthermore, birdshot fundus lesions do not usually become highly hyperpigmented even after long-term evolution. This pigmentation may represent one type of the end-stage of birdshot retinochoroidopathy.