Histological findings of birdshot chorioretinopathy in an eye with ciliochoroidal melanoma

Purpose To describe the histological findings of birdshot chorioretinopathy. Design/participant This is a case study of a single patient who has both birdshot chorioretinopathy and ciliochoroidal melanoma. Methods A 55-year-old woman who was HLA-A29 positive and had birdshot chorioretinopathy had a large ciliochoroidal melanoma (T4b N0 M0) and underwent enucleation. Outcome measures Using histopathology, we hope to further define the pathological findings in an eye with both birdshot chorioretinopathy and coexistant ciliochoroidal melanomas. Results The eye showed a ciliochoroidal melanoma. In addition, elsewhere, there were multiple choroidal nodules of lymphocytes that showed the presence of CD3-positive cells, which also stained for CD4 or CD8. There were only a few CD20-positive B cells and rare CD68-positive histiocytes. No granulomas were present. Discussion To our knowledge, there are only two previous reports describing the histological findings in birdshot chorioretinopathy: one that was HLA-A29 negative showing choroidal granulomas and another that was HLA-A29 positive exhibiting histological findings similar to our case. Incidentally, the latter case had a history of cutaneous melanoma. Conclusion Birdshot chorioretinopathy is a nongranulomatous nodular infiltration of the choroid. Eye (2012) 26, 862-865; doi:10.1038/eye.2012.10; published online 9 March 2012