We have recently posted about the importance of ensuring that we get the right diagnosis, testing and monitoring for Birdshot as other diseases can often look like Birdshot, but will require totally different treatments. A research paper from the Massachusetts Eye and Ear infirmary in Boston has recently been published, and builds on this theme.
The paper examines ways in which to test and monitor for Birdshot, and is really useful in helping us understand the monitoring tests we get, and why we get them.
In short, the paper explains that it is critical to diagnose and carefully monitor Birdshot as it can progress insidiuously without any associated pain, and looking just for visual acuity, inflammation or vascular leakage of fluorescein alone, may not be effective.
The authors of the paper review the current methods of diagnosing, testing and monitoring for Birdshot including ERGs, fluorescine angiography, indocyanine green angiography, OCTs, visual field tests and HLA A29 blood testing.
The major finding is that 70% of people with Birdshot have abnormal readings on one of the parameters (the 30 hz flicker) of ERGs. This is really interesting, as it means that ERGs may be a fairly good way to help diagnose Birdshot. It also could mean that if we have a ‘normal’ 30 hz flicker result, we may be able to reduce our medication.
This does not mean, of course, that we can do without some of the other monitoring – each system has its uses. For example, OCT is particularly pertinent if you have macular oedema, and we posted recently about the importance of indocyanine green angiography. However, it does help us, as patients with Birdshot, understand why all these tests are so very important in ensuring that we maintain our visual acuity and are not under or over medicated, and that our medication regimes are effective.
Read the full article by clicking the link below.
AUTHORS: Comander J, Loewenstein J, Sobrin L