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J. Lee, S. Park, J. Lee, B. Oum; Photoreceptor Layer Separation on Optical Coherance Tomography in Vogt-koyanagi-harada Disease. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5129.
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Optical coherence tomography (OCT) images of patients showing serous retinal detachment with Vogt-Koyanagi-Harada disease were evaluated according to the location of the fluid to find correlation with clinical findings.
Twenty-eight eyes of 14 patients were reviewed retrospectively. Based on the location of the fluid on the OCT, the eyes were divided into 2 groups; group I, with intraretinal fluid and group II, without intraretinal fluid. All patients were treated with high-dose intravenous methyl-prednisolone for 3 to 7 days and then oral steroid for 3 to 6 months. Clinical findings including visual acuity and change of the intra/subretinal fluid were compared between the groups.
Nineteen eyes were group I and nine eyes were group II. Initial visual acuity in group I was 0.15 of median (0.02-1.0) and significantly worse than that of group II (0.6, range 0.1-1.0). In group I, OCT revealed the photoreceptor layer seperation and the intraretinal fluid collected in the outer retina. The intraretinal fluid was resolved earlier than the subretinal fluid during steroid therapy. Significant difference was not found in visual acuity between two groups later than 4 days. At 3 months, visual acuity was 1.0 of median in the both groups.
Separation of the photoreceptor layer could be identified on OCT in VKH disease. These findings may implicate the mechanism of the autoimmunity in VKH disease and would explain the poor inital visual acuity. Good functional outcome was achieved with systemic steroid therapy regardless of the location of the fluid.
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