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Presentation type	E-poster
Title	Atypical Birdshot Chorioretinopathy Mimicking Lymphoma: A Case Report

Purpose	Birdshot chorioretinopathy (BSCR) is a rare pathology, representing 1 % of uveitis. We present the case of an intraocular lymphoma-like BSCR presentation.
Methods	We report the case of a 49-year-old male caucasian patient referred for assessment in the context of visual blur (10/10 RE and 8/10 LE) for few weeks, and diffuse loss of sensitivity in the visual field. He had no particular family history and no medication. Slit-lamp examination revealed calm anterior chambers and no structural abnormalities. Fundus examination showed bilateral vitritis, with peripheral vasculitis. Fluoangiography (FA) demonstrated early hypofluorescent patches with late staining patterns with a “leopard spot appearance”, and leakage at the optic nerves. Optic Coherence Tomography (OCT) showed vitreous cells, epiretinal membrane, hyper-reflective foci and IS-OS disruptions. A workup was done: blood test for posterior uveitis (syphilis, tuberculosis, ACE), chest CT scan to rule out granulomatosis and MRI for possible lymphomatous lesions or white matter lesions. Empirical treatment with local corticosteroids is initiated. Our suspicion was primary intraocular lymphoma, given the aspect of retinal and vitreous involvement.
Results	The work up was negative. The possibility of a BSCR was evoked, even if the typical cream-colored choroidal lesions were not seen at fundus. HLA A29 was tested and further history was taken. Indeed, his visual blur increased after dark. Night blindness is an usual symptom in BSCR. HLA A-29 was positive, confirming our last suspicion. Oral corticoids and mycophenolate mofetil was instituted and the patient rapidly improved.
Conclusion	BSCR can be symptomatic, while fundus examination is not very informative. Its presentation may be atypical and mimic an intraocular lymphoma.
Conflict of interest	No

Authors 1

Last name	AFIFI
Initials	Y
Department	Department of ophthalmology, CHU Saint-Pierre
City	Brussels

Authors 2

Last name	HAKAMI
Initials	S
Department	Department of ophthalmology, CHU Saint-Pierre
City	Brussels

Authors 3

Last name	MISSA
Initials	E
Department	Department of ophthalmology, CHU Saint-Pierre
City	Brussels

Authors 4

Last name	MAKHOUL
Initials	D
Department	Department of ophthalmology, CHU Saint-Pierre
City	Brussels

Authors 5

Last name	WILLERMAIN
Initials	F
Department	Department of ophthalmology, CHU Saint-Pierre
City	Brussels

Authors 6

Last name	LE
Initials	A
Department	Department of ophthalmology, CHU Saint-Pierre
City	Brussels