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H. Koizumi, K. Maruyama, S. Kinoshita; Fundus Autofluorescence Indicates Choroidal Inflammation in Acute Vogt-Koyanagi-Harada Disease. Invest. Ophthalmol. Vis. Sci. 2009;50(13):6027.
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To investigate the characteristics of fundus autofluorescence (AF) in acute Vogt-Koyanagi-Harada disease (VKH).
This study included 10 eyes of five patients (two men and three women, mean age: 41 years) with acute VKH. We performed AF photography with blue light (BL-AF) and near-infrared light (NIR-AF) using a confocal scanning laser ophthalmoscope before and after treatment. The AF images were retrospectively compared with color fundus photographs, fluorescein and indocyanine green angiograms, and optical coherence tomograms.
At the initial visit, all 10 eyes showed serous retinal detachment in the macula. The BL-AF and the NIR-AF images demonstrated corresponding hypoautofluorescence or isoautofluorescence in various degrees. After resolution of the retinal detachment, the BL-AF and the NIR-AF images revealed identical patterns of granular or placoid hyperautofluorescent areas in the macula in all eyes, but more evidently in the NIR-AF images. Those hyperautofluorescent areas corresponded to the multifocal hypofluorescence seen in indocyanine green angiography only in the posterior pole. Four eyes showed radial hyperautofluorescence around the optic disc in both modes. The hyperautofluorescent areas reduced in size and in number with time and were gradually concentrated on the central fovea regardless of recurrent choroidal inflammation. With optical coherence tomography, the hyperautofluorescent areas consistently demonstrated irregularity in the hyperreflective line of retinal pigment epithelium.
The hyperautofluorescence, which was more evident in the NIR-AF images, is possibly related to the choroidal inflammation in acute VKH.
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