Enhanced Depth Imaging Optical Coherence Tomography in long- standing Vogt-Koyanagi-Harada disease

Abstract

 

Purpose:

 

To evaluate choroidal thickness utilizing enhanced depth imaging spectral optical coherence tomography (EDI-SOCT) in patients with long-standing Vogt-Koyanagi-Harada (VKH) disease.

 

Methods:

 

Twenty-three eyes of 13 patients with VKH disease with more than 6 months of disease onset were included. Age-matched historical normative values for choroidal thickness were used. Main outcome measures were choroidal thickness measurements on EDI-SOCT in 13 different points across the posterior pole centered in the fovea as well as the correlation of choroidal thickness with disease duration, fundoscopic severity grading, clinical disease chronicity (according to the S.U.N. working group) and the integrity of the photoreceptors’ inner and outer segments junction (IS/OS) on SOCT.

 

Results:

 

The median choroidal thickness was significantly reduced in patients with long-standing VKH disease (245 µm) compared with normal subjects (287 µm; p<0.05). Choroidal thickness measurements in patients with VKH disease followed a pattern similar to those observed in normal subjects, being thickest beneath the fovea (169 µm) with rapid decrease in the nasal direction at 3 mm to the fovea (145 µm). Choroidal thickness tended to decrease with disease duration (r = -0.4; p=0.056), fundoscopic severity grading (mild = 278 µm, moderate = 265 µm, and severe = 193 µm; p=0.175), disease chronicity (262 µm vs 162 µm; p=0.067), and disruption of the IS/OS junction integrity (270 µm vs 217 µm; p=0.267).

 

Conclusions:

 

The choroid was diffusely thinned in the posterior pole of patients with long-standing VKH disease. Thinning of the choroid in the posterior pole was associated to some extent with duration of the disease, fundoscopic severity grading, disease chronicity and disruption of the IS/OS.  

 

Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • choroid • uvea