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PubMed This is a summary of 16 peer-reviewed journal articles Updated
Ophthalmology

Long-Term Monitoring & Your Care Team

At a Glance

Birdshot chorioretinopathy can remain active without obvious symptoms, so regular eye exams, retinal scans, and vision tests are important. A coordinated uveitis and medication team uses these results to adjust care, protect remaining vision, and support quality of life.

Managing Birdshot Chorioretinopathy (BSCR) is not about a quick fix; it is about establishing a “new normal” of long-term vigilance. Because Birdshot can be active even when you feel fine, your care relies on a specialized team and a consistent schedule of advanced testing to protect your vision [1][2].

The Long-Term Outlook

Because Birdshot is a highly individualized disease, prognoses vary. Some patients experience an indolent, slow-moving course, while others may face earlier, irreversible vision loss due to active vasculitis, macular edema, or retinal atrophy [3][4].

With modern immunomodulatory therapy (IMT), many patients are able to achieve periods of sustained remission, though this often requires staying on medication for years [5]. The goal of treatment is to stabilize the disease and preserve your current function, recognizing that while existing structural damage may not reverse, future damage can often be prevented.

Your Multidisciplinary Care Team

Birdshot is a disease that sits at the intersection of ophthalmology and immunology. The structure of your care team may vary depending on your clinic:

  • The Uveitis Specialist: This is your central ophthalmologist, with extra training in inflammatory eye diseases. They interpret your specialized eye scans (ICGA, ERG, OCT) and evaluate ocular activity [6].
  • The Rheumatologist / Immunologist: Many uveitis specialists partner with a rheumatologist or internal medicine doctor to prescribe and monitor your systemic medications. They are experts in managing immune-suppressing drugs and monitoring your blood work for side effects [7][8]. Ensure you know exactly who is responsible for managing your prescriptions and lab orders.
  • Support Services: Over time, you may benefit from low-vision rehabilitation (to help with glare, reading, or night driving adaptations), workplace accommodations, or mental health professionals to help manage the emotional burden of a chronic condition [7][9].

The Monitoring Cycle

Your testing schedule will be individualized. You will likely have more frequent visits during active disease or medication changes, and longer intervals only after sustained stability.

Your team relies on complementary tests to evaluate your status:

  1. Structural (OCT): These scans check for swelling or thinning of the retina [6][10].
  2. Functional (ERG and Visual Fields): These tests measure how your eye works. The ERG (especially the 30-Hz flicker) can help track retinal dysfunction over time, while visual fields map your peripheral vision [11][2].
  3. Vascular (FA and ICGA): These dye tests are typically done less frequently once you are stable, but they help assess retinal blood vessel leakage (FA) and choroidal inflammation (ICGA) [6][12].

No single test captures every aspect of Birdshot. Treatment decisions balance active inflammation, accumulated structural damage, your symptoms, medication side effects, and your quality of life.

Managing the Psychological Toll

“Scan anxiety”—the stress felt before a major monitoring appointment—is a very real part of the Birdshot experience [9]. Chronic uveitis is associated with higher rates of anxiety and perceived stress, often because the disease can feel unpredictable [13][9].

Patients who feel they have a good understanding of their condition often report lower levels of distress [14]. Be open with your team about how the disease affects your ability to drive at night, read for long periods, or work. A stable scan is a victory, but your functional quality of life is the ultimate goal of the partnership with your care team [15][16].

Common questions in this guide

Why do I need Birdshot monitoring if I feel well?
Birdshot chorioretinopathy can be active before you notice a change in vision. Regular examinations and testing can detect inflammation, retinal swelling, thinning, or loss of function early enough for your team to consider whether treatment should change.
What does each Birdshot eye test measure?
OCT looks for retinal swelling or thinning. ERG and visual-field testing measure how the retina and vision are functioning, while fluorescein angiography and indocyanine green angiography can assess blood-vessel leakage and choroidal inflammation.
How often will I need ERG, OCT, and other Birdshot tests?
Your schedule depends on disease activity, medication changes, and how long your results have been stable. Visits are usually more frequent during active disease or treatment changes, while some dye tests and other monitoring may be spaced farther apart after sustained stability.
Who manages my Birdshot medications and blood tests?
A uveitis specialist often leads the eye care, while a rheumatologist, immunologist, or internal medicine clinician may prescribe and monitor systemic medication and blood work. Ask your clinicians to clarify who handles prescriptions, lab orders, and urgent questions.
Can treatment reverse vision damage from Birdshot chorioretinopathy?
Immunomodulatory therapy can help control inflammation and may allow periods of remission, but it usually cannot reverse structural damage that has already occurred. The main goal is to preserve current vision and prevent additional damage while balancing medication risks.
What can I do about anxiety before Birdshot testing?
Tell your care team if scan anxiety, stress, or vision-related limitations are affecting daily life. They may connect you with mental-health support, low-vision rehabilitation, workplace resources, or other practical help.

Questions For You

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Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.Who is the primary contact for managing my systemic medications—is it you, a partnered rheumatologist, or my primary care doctor?
  2. 2.How frequently should I expect to have 'big' testing days (ERG and visual fields) versus standard monitoring visits (OCT and exam)?
  3. 3.Are my current ERG and visual field results stable, and what specific change in those numbers would prompt a change in my treatment?
  4. 4.Can you provide a summary of my baseline tests so I can compare them with future results to track my own progress?
  5. 5.What resources, support groups, or low-vision specialists do you recommend for patients dealing with chronic uveitis?

References

References (16)
  1. 1

    Efficacy and safety of abatacept to treat active birdshot uveitis: a prospective open label interventional proof-of-concept trial.

    Schauwvlieghe PP, Van Calster J, Herbort CP, et al.

    The British journal of ophthalmology 2024; (108(2)):244-252 doi:10.1136/bjo-2022-321585.

    PMID: 36585127
  2. 2

    Five-Year Trends in Multifocal Electroretinogram for Patients With Birdshot Chorioretinopathy.

    Mailhac A, Labarere J, Aptel F, et al.

    American journal of ophthalmology 2019; (200()):138-149 doi:10.1016/j.ajo.2018.11.022.

    PMID: 30557530
  3. 3

    Visual acuity and visual field as a function of disease duration in patients with birdshot chorioretinitis.

    Loeliger J, Monnet D, Thorne J, et al.

    The British journal of ophthalmology 2024; (108(11)):1543-1547 doi:10.1136/bjo-2023-324636.

    PMID: 38508674
  4. 4

    EVALUATION OF PHOTORECEPTORS, RETINAL CAPILLARY PLEXUSES, AND CHORIOCAPILLARIS IN PATIENTS WITH BIRDSHOT CHORIORETINOPATHY.

    Forte R, Saleh M, Aptel F, Chiquet C

    Retina (Philadelphia, Pa.) 2020; (40(5)):977-988 doi:10.1097/IAE.0000000000002457.

    PMID: 30789462
  5. 5

    Long-term outcomes of systemic corticosteroid-sparing immunomodulatory therapy for Birdshot Retinochoroidopathy.

    You C, Lasave AF, Kubaisi B, et al.

    Ocular immunology and inflammation 2020; (28(6)):966-974 doi:10.1080/09273948.2019.1641610.

    PMID: 31567006
  6. 6

    Evidence and Consensus-based Imaging Guidelines in Birdshot Chorioretinopathy: Multimodal Imaging in Uveitis (MUV) Taskforce Report 8.

    Pichi F, Miserocchi E, Grewal DS, et al.

    American journal of ophthalmology 2025; (278()):271-281 doi:10.1016/j.ajo.2025.06.029.

    PMID: 40545009
  7. 7

    Update on the systemic management of noninfectious uveitis in children and adolescents.

    Leal I, Steeples LR, Wong SW, et al.

    Survey of ophthalmology 2024; (69(1)):103-121 doi:10.1016/j.survophthal.2023.01.002.

    PMID: 36682467
  8. 8

    Prognostic Factors of Treatment Failure with First-Line Corticosteroid-Sparing Agents in Patients with Birdshot Chorioretinopathy: A Retrospective Study.

    Goupillou P, Leclercq M, Muraine M, et al.

    Ocular immunology and inflammation 2025; (33(7)):1298-1302 doi:10.1080/09273948.2025.2491570.

    PMID: 40262577
  9. 9

    Incidence and Prevalence of Depression, Anxiety, and Suicidal Ideation in Patients with Uveitis and Scleritis in the TriNetX Database.

    Agarwal R, Lee D, Mendez Bermudez I, Berkenstock MK

    Ocular immunology and inflammation 2026; 1-9 doi:10.1080/09273948.2026.2633447.

    PMID: 41824366
  10. 10

    Spectrum of Imaging Characteristics of Birdshot Chorioretinopathy.

    Kherani S, Alapati A, Kaisari E, et al.

    Ocular immunology and inflammation 2025; (33(7)):1399-1407 doi:10.1080/09273948.2024.2448529.

    PMID: 39781643
  11. 11

    Visual Electrodiagnostic Testing in Birdshot Chorioretinopathy.

    Tzekov R, Madow B

    Journal of ophthalmology 2015; (2015()):680215 doi:10.1155/2015/680215.

    PMID: 26246903
  12. 12

    BIRDSHOT CHORIORETINITIS LESIONS ON INDOCYANINE GREEN ANGIOGRAPHY AS AN INDICATOR OF DISEASE ACTIVITY.

    Cao JH, Silpa-Archa S, Freitas-Neto CA, Foster CS

    Retina (Philadelphia, Pa.) 2016; (36(9)):1751-7 doi:10.1097/IAE.0000000000000967.

    PMID: 26977742
  13. 13

    Association Between Noninfectious Uveitis and Psychological Stress.

    Berlinberg EJ, Gonzales JA, Doan T, Acharya NR

    JAMA ophthalmology 2019; (137(2)):199-205 doi:10.1001/jamaophthalmol.2018.5893.

    PMID: 30520957
  14. 14

    Anxiety and Depression among Patients with Uveitis and Ocular Inflammatory Disease at a Tertiary Center in Southern Thailand: Vision-Related Quality of Life, Sociodemographics, and Clinical Characteristics Associated.

    Sittivarakul W, Wongkot P

    Ocular immunology and inflammation 2019; (27(5)):731-742 doi:10.1080/09273948.2018.1484495.

    PMID: 29969331
  15. 15

    Quality of Life in Patients with Birdshot Chorioretinitis Aged 80 and Older.

    Kaisari E, Loeliger J, Thorne JE, et al.

    Ocular immunology and inflammation 2025; (33(2)):280-286 doi:10.1080/09273948.2024.2400172.

    PMID: 39250617
  16. 16

    Creating a Health Utility Value for Birdshot Chorioretinopathy.

    Sekaran A, Shamdas M, Barry RJ, et al.

    Ocular immunology and inflammation 2022; (30(1)):73-80 doi:10.1080/09273948.2020.1799034.

    PMID: 32946293

This page is for informational purposes only and does not constitute medical advice about Birdshot chorioretinopathy. Your uveitis specialist and medication-prescribing clinician can tailor monitoring, treatment, and support to your situation.