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Makiko Nakayama, Hiroshi Keino, Takayo Watanabe, Makoto Inoue, Akito Hirakata, Annabelle A. Okada; Enhanced Depth Imaging Optical Coherence Tomography Of The Choroid In New-onset Acute Vogt-Koyanagi-Harada Disease. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2744.
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© ARVO (1962-2015); The Authors (2016-present)
Diffuse choroiditis is an early manifestation of acute Vogt-Koyanagi-Harada (VKH) disease. Recent studies have shown that optical coherence tomography (OCT) when using enhanced depth imaging (EDI) can image the full-thickness of choroid. The purpose of this study was to analyze subfoveal choroidal thickness as measured by EDI-OCT before and after initiation of high dose corticosteroid treatment in 6 patients (12 eyes) with new-onset acute VKH disease.
Retrospective review of clinical records. EDI-OCT was performed using the Heidelberg Spectralis.
The outer border of the choroid was not detectable by EDI-OCT in any patients before treatment, presumably due to marked choroidal inflammation and/or thickening. Choroidal thickness became measureable at 1 week and gradually decreased in each patient after initiation of treatment (mean choroidal thickness, 1 week: 576 µm, 1 month: 406 µm, 3 months: 421 µm, 6 months; 421 µm). Rebound of choroidal thickening was observed in 3 patients (5 eyes) during corticosteroid tapering despite absence of other evidence of increased inflammation. Three of 5 eyes (60%) with choroidal thickness rebound developed peripapillary atrophy, whereas 6 of 7 eyes (86%) without rebound had no peripapillary atrophy at 6 months.
EDI-OCT enabled visualization of the choroid in patients with acute VKH disease, with decreased choroidal thickness observable during corticosteroid tapering. These results suggest that choroidal thickness as measured by EDI-OCT may serve as a marker for degree of choroiditis during the acute phase of VKH disease, and may aid in assessing possible subclinical choroidal inflammation noninvasively during corticosteroid tapering.
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