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Hiroyuki Takahashi, Hiroshi Takase, Noriaki Shimada, Kyoko Ohno-Matsui, Manabu Mochizuki; Myopia Progression Accompanying with Myopic Disc Change at the Convalescent Stage of Vogt-Koyanagi-Harada Disease. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5868.
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It has been reported that Vogt-Koyanagi-Harada (VKH) disease at the convalescent stage shows a marked choroidal thinning, as seen in eyes with pathologic myopia. However, it is not clear if VKH disease causes development or progression of myopia. We examined myopia progression and myopic disc changes in patients with VKH disease at its convalescent stage.
Medical records of 25 VKH patients (49 eyes) whose disease duration was more than 1 year were reviewed. The ocular manifestations at the onset of the disease, and the long-term changes of refractive error and deformation of the optic disc, i.e. tilted disc and the development of conus, were investigated. Ovality of the optic disc was expressed as the ratio of vertical / horizontal disc diameter, and the myopic disc tilting was defined as the ovality change rate > 1.2. The changes of axial length (AL) were also investigated in 14 eyes of 7 patients, including 4 phakic eyes and 10 pseudophakic eyes at the initial examination.
The mean follow up period was 5.0 (range; 1.1 to 11.9) years. None of them had cataract or refractive surgery during a follow-up. The mean myopic refractive error at the final examination was significantly greater than that at the initial examination(-2.58 diopter (D) Vs -1.66 D, P=0.0004; paired t test). The refractive error remained stable (<2.0 D difference) in 42 eyes, whereas the refractive error changed by >2.0 D in 7 eyes. Among the 14 eyes whose changes in AL were examined, the AL remained stable (<0.1 mm/year difference) in 9 eyes, whereas AL increased by >0.1mm/year in 5 eyes. Tilting disc and/or conus formation occurred in 12 eyes (Figure). The incidence of papillitis, serous retinal detachment, and hypotony at onset were not different significantly between myopic progressive eyes and stable eyes.
VKH patients showed progression of myopia and myopic disc changes in the convalescent stage of the disease. Although further studies are necessary, the choroidal thinning secondary to VKH might be related to myopic progression.
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