Reactive lymphoid hyperplasia of the uvea in a patient with birdshot chorioretinopathy

An HLA-A29-positive 82-year-old female diagnosed with birdshot chorioretinopathy 15 years earlier presented with recurrent floaters and blurred vision in the right eye. In addition to increased vitreous haze, fundus examination showed multifocal yellow–orange choroidal lesions. These infiltrates corresponded to focal areas of hyporeflective choroidal thickening with optical coherence tomography (Fig. A) consistent with birdshot-related inflammatory infiltrates versus benign reactive lymphoid hyperplasia. Treatment with oral prednisone led to symptomatic improvement and anatomic resolution of the choroidal infiltrate within 4 weeks (Fig. B).