Inner neuroretinopathy (birdshot or vitiliginous retinopathy)

Abstract

A 62-year-old male patient (six-year follow-up) is reported presenting with night-blindness, a fundus pattern characteristic of birdshot retinopathy and subclinical ataxia due to generalized peripheral neuropathy. Although associated with HLA-A29 and B12, there was only a paravascular retinal pigment epithelial (RPE) staining indicative of prior leakage due to retinal vasculopathy. The authors consider this case as birdshot or vitiliginous retinopathy with initial silent subclinical inflammatory component, but suggest to coin the disease inner neuroretinopathy, as the probable primary topography of the lesion are the inner retinal layers.

A second case concerns a 48-year-old female (nine-year follow-up) who presented initially with bilateral pars planitis and retinal vasculopathy associated with HLA-A29. After four years she developed progressively a birdshot retinopathy with nightblindness. To the authors' knowledge, this is the first case described in the literature in which a birdshot retinopathy with nightblindness developed after a pars planitis with vasculopathy.

Key Words:

• nightblindness
• birdshot retinopathy
• vasculitis
• HLA-A29