Purchase this article with an account.
Kiyoko Gocho, Sachiko Kikuchi, Takenori Kabuto, Hisatomo Takahashi, Shuhei Kameya, Kunihiko Yamaki, Hiroshi Takahashi; High Resolution Imaging with Adaptive Optics in Patients with Vogt-Koyanagi Harada Disease. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3442.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To report the findings of en face adaptive optics (AO) fundus imaging in eyes with Vogt-Koyanagi-Harada disease (VKH) patients.
The macular region of five eyes from different stage of four VKH patients with a mean age of 39 (range 21-60) were imaged using both an infrared AO camera (rtx1™, Imagine Eyes, France) and spectral-domain optical coherence tomography (SD-OCT - Cirrus™, Carl Zeiss Meditec, Germany). AO images were analyzed for cone density at 600μm and 1200μm nasal from the foveola. The data acquired from the VKH patients was then compared to that acquired from the eyes of 21 healthy volunteers with a mean age of 36 years (range 20-57) at the same eccentricities.
The mean cone densities in healthy retinas were 2.11±0.37 x104 and 1.70±0.31 x104 cones/mm2 at eccentricities 600μm and 1200μm respectively. One acute phase VHK patient was presented after 2 weeks from the onset, diagnosed with serous retinal detachment (SRD) and treated using steroid pulse treatment, underwent AO and SD-OCT at follow-up visits over 16th weeks. Analysis of the AO images enabled us to determine that the cone density at the 4th, 5th, 13th and 16th week from onset was 1.17x104, 0.78x104, 1.16x104 and 2.21x104 cones/mm2 at 600μm respectively, and 0.95 x104, 1.02 x104, 1.54 x104 and 1.61 x104 cones/mm2 at 1200μm respectively. At 16th week, even the cone density of the patient was within the range of the standard deviation of healthy volunteers, patchy dark areas with decreased cone were observed. OCT showed recovery from SRD, but hypo-reflectance in the cone outer segment tip (COST) line. Another patient who was treated with steroid pulse treatment just after the onset cured SRD, the COST line showed normal reflectance and AO cone counting was within normal range of healthy volunteers at both 600μm and 1200μm. In two very late stage patients with sunset-glow fundus at more than 2 years after the onset, analysis of AO showed an irregularity in cone density at both 600μm and 1200μm eccentricities, even though patients’ visual acuity were better than 20/20.
We have found that the photoreceptor damage remain longer even after serous retinal detachment was resolved with OCT in the convalescent and chronic stage VKH patients. Combined examinations using AO and SD-OCT may be useful in better understanding and managing the ophthalmic consequences of VHK disease.
This PDF is available to Subscribers Only