Birdshot uveitis: current and emerging  treatment options is the title of a recently published paper by Victor Menezo from Institut Catala de Retina, Barcelona, Spain; Department of Ophthalmology, Provincial Hospital Consortium Castellon, Castello, Spain and Simon R J Taylor  Faculty of Medicine, Imperial College London, Hammersmith Hospital, London, UK; Royal Surrey County Hospital NHS Foundation Trust, Guildford

(Note: the whole paper can be downloaded as a pdf by following the link above and scrolling to the bottom of the abstract.)

This paper provides a comprehensive summary of current  tests and treatments available for Birdshot Uveitis.  It clearly makes the important point that, although central visual acuity can be preserved until late in the disease, it is not uncommon for patients to receive inadequate immunosuppressive treatment, leading to a poor long-term outcome in which peripheral retinal damage eventually leads to visual deterioration.

It also states that  although “laboratory research continues to investigate the underlying mechanisms of disease, and clinical research is now being driven to improve the phenotyping and monitoring of this condition, it is becoming increasingly important to identify patients at risk of visual loss early so that they can be treated more aggressively with targeted therapies such as the newer biological agents.”

It states that “this approach requires the formation of collaborative groups, as the relative rarity of the condition makes it difficult for one center to accumulate enough patients for worthwhile studies. Nevertheless, results obtained with newer therapies, such as biological agents directed against particular cytokines or cell-surface receptors, demonstrate ever improving control of the inflammation in refractory cases, providing hope that the outlook for visual function in this condition can only improve.”

This paper certainly gives BUS hope.  It is gratifying that it clearly endorses our belief about the best way forward, just at the point when we are getting collaborative work off the ground with the National Birdshot Research Network; and the development of the Birdshot bio-resource centre and Birdshot database.