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M. Khairallah, B. Jelliti, S. Gargouri, W. Hasnaoui, S. Jenzeri, S. Zaouali, S. Ben Yahia, R. Messaoud; Indocyanine Green Angiography in Acute Vogt Koyanagi Harada Disease: Signs at Presentation and Their Evolution Under Treatment. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5879.
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© ARVO (1962-2015); The Authors (2016-present)
To report indocyanine green (ICG) angiographic findings in acute Vogt-Koyanagi-Harada (VKH) disease at initial examination and during follow-up.
Nineteen consecutive patients (38 eyes) with VKH disease in the acute phase with bilateral serous retinal detachment were included. All the patients underwent a complete ophthalmic evaluation, fluorescein angiography, and ICG angiography at initial examination before starting corticosteroids. Ten of 19 patients also underwent repeated ICG angiographies (month one, month three, and every three months) for at least 6 months.
Angiographic signs at presentation included choriocapillaris filling delay/defect (36 eyes; 94.7%), multiple hypofluorescent spots scattered throughout the fundus in the early (4 eyes; 10.5%) or intermediate phase (32 eyes; 84.2%), perivascular leakage (34 eyes; 89.5%), areas of choroidal hyperfluorescence in the late phase (14 eyes; 36.8%), hyperfluorescent pinpoints (14 eyes; 36.8%), and optic disc hyperfluorescence (18 eyes; 47.4%). A decrease in the number of choroidal vessels, when comparing consecutive ICG angiographic examinations, could be confirmed in 18 of the 20 eyes (90%) with repeated ICG. It was also strongly suspected in 16 of 18 eyes (88.9%) with only one ICG angiographic examination. All the signs gradually decreased during follow-up to disappear completely at six month follow-up angiography except hypofluorescent spots which persisted for more than 12 months in 6 of 20 eyes (30%).
ICG angiography provides a detailed extent of choroidal involvement in acute VKH disease. It is also a useful tool in monitoring the disease and guiding the tapering of corticosteroids.
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