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Yoshikatsu Hosoda, Akihito Uji, Masanori Hangai, Satoshi Morooka, Kazuaki Nishijima, Nagahisa Yoshimura; Relationship between Retinal Lesions and Inward Choroidal Bulging in Vogt-Koyanagi-Harada Disease. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1132.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the correlation between choroidal and retinal lesions in acute Vokt-Koyanagi-Harada (VKH) disease eyes using optical coherence tomography (OCT).
Forty-two eyes (22 patients) with acute VKH underwent steroid therapy. Ophthalmic evaluations included best corrected visual acuity (BCVA) measurement, spectral domain OCT (SD-OCT) imaging, swept source OCT imaging, and axial length measurement. Correlations between BCVA, axial length change, and OCT parameters (e.g., retinal thickness, choroidal thickness, bumpy choroidal deformations) were examined. The SD-OCT images were used to define the choroidal fold index (CFI), a new parameter that quantitatively describes choroidal deformations. The CFI is the retinal pigment epithelium line length to the total scan length (6 mm) ratio on a foveal-centered scan. The average of individual CFI measurements, obtained from a vertical and a horizontal scan, was used in analyses.
Eyes with acute VKH showed choroidal and retinal thickening, which were reduced following steroidal treatment (all P <0.001). Axial length changes were significantly correlated with both choroidal thickness (r = 0.842, P <0.001) and CFI (r = 0.600, P = 0.014). Additionally, CFI was related to choroidal thickness (r = 0.624, P = 0.004), retinal thickness (r = 0.483, P = 0.003), and BCVA (r = 0.588, P <0.001).
In eyes with acute VKH, the choroid was diffusely thickened and bulged inward. Correlations between CFI and choroid morphology, retinal thickness, and poor BCVA suggest that choroidal folding, quantified by CFI, is useful in assessing VKH disease severity
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