Abstract
Purpose: :
To report the concomitant use of autofluorescence (AF) and spectral-domain optical coherence tomography (SDOCT) imaging to better assess the status of retinal pigment epithelium (RPE) and outer retina in subjects with chronic Vogt-Koyanagi-Harada disease (VKH).
Methods: :
A cross-sectional analysis was performed on a series of consecutive patients with chronic VKH who underwent AF and SDOCT imaging with the Spectralis HRA+OCT (Heidelberg Engineering, Vista, CA). Chronic VKH was defined as that with duration > 3 months. Demographic and clinical data were collected. Images were evaluated in conjunction with certified AF and OCT graders from the Doheny Image Reading Center to specifically classify outer retinal abnormalities.
Results: :
Most patients were women (75%) and hispanic (75%), with an average age of 39±6.5 years. According to the revised criteria, 4 subjects had incomplete and 4 had probable VKH. Two patients had active intraocular inflammation at the time of examination and 6 were on prednisone and/or other immunosuppressive drugs. Best corrected visual acuity ranged from 20/20 to 20/80. Three patients (4 eyes) showed well-demarcated nummular hypoAF lesions in the posterior pole, with corresponding disruption of the junction of the inner and outer segments of the photoreceptors and loss of the RPE layer on SDOCT. Two patients (4 eyes) had areas of granular hyperAF which correlated with mildly irregular contour of the RPE layer. One patient had irregular patches of moderate hypoAF with sparing of the outer segments of the photoreceptors. Variegated patches of hyper and hypoAF were present in 1 patient with bilateral subretinal RPE proliferation, and 2 eyes of 2 patients with disciform scars showed hypoAF corresponding to the lesions. All cases showed variable sunset glow fundus with no apparent corresponding abnormalities on AF or OCT.
Keywords: uveitis-clinical/animal model • imaging/image analysis: clinical • retinal pigment epithelium