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Kouhei Hashizume, Yutaka Imamura, Takamitsu Fujiwara, Shigeki Machida, Masahiro Ishida, Daijiro Kurosaka; Retinal pigment epithelium striations in Vogt-Koyanagi-Harada disease: A new biomarker for visual prognosis. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5802.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the clinical significance of retinal pigment epithelium (RPE) striations in the acute stage of Vogt-Koyanagi-Harada disease.
RPE striations in eyes with acute VKH were detected using EDI-OCT and classified into 4 grading scales (grade 1: no striation, grade 2: small striations, grade 3: middle striatiosn, grade 4: large striations) by 2 independent examiners. The relation between clinical characteristics and grading of RPE striations was investigated.
Among 47 eyes of 24 patients with acute VKH (mean age: 50 years), 32 (68 %) eyes showed RPE striations; grade 1: 15 (32 %) eyes, grade 2: 8 (17 %) eyes, grade 3: 13 (28 %), and grade 4: 11 (23 %) respectively. The patients with RPE striations in either eye were older at onset (p < 0.001) and longer duration of subjective visual disturbance at first visit (p < 0.05) than those without striations. The eyes with RPE striations showed larger choroidal thickness before high-dose steroid therapy (p < 0.01). Multiple regression analysis revealed that grading scores of RPE striations were independent predictor of frequent posterior recurrences (p < 0.05) and poor visual acuity at final visit (p < 0.05).
RPE striations detected by EDI-OCT are relatively frequent in the acute stage of VKH, and strong RPE striations appear to be a possible risk factor of posterior recurrence and poor visual acuity after high-dose steroid therapy.
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