Follow-Up of Fundus Autofluorescence in Vogt-Koyanagi-Harada Disease Before and After Steroid Treatment

Abstract

Purpose: : To elucidate the distribution of fundus autofluorescence (FAF) before and after steroid treatment in patients with Vogt-Koyanagi-Harada disease (VKH).

Methods: : Clinical courses of 14 eyes of 7 patients with VKH were followed before and after steroid treatment for at least two years or more. VKH was diagnosed based on findings from clinical symptomatology, ophthalmoscopy, fluorescein angiography (FA) and examination of cerebrospinal fluid. FAF images were taken using a Heidelberg retina angiogram. Averaging of sequential FAF images was done for noise reduction.

Results: : In the active stage, serous retinal detachment (SRD) and fluorescein leakage of FA was noted in 6 of 7 patients. On FAF images, the area of the SRD was hypofluorescent, and increased FAF was noted around the SRD areas. One month after steroid treatment, SRD was absent, and hypofluorescent area of FAF corresponding to the previous SRD areas had disappeared. The increased FAF lesions remained in various degrees in 12 eyes. During the follow-up examination, the increased FAF lesions were reduced in size with time. But. some increased FAF lesions remained even after 2 years in 6 of 12 eyes. On the remaining patient without SRD or diffuse leakage from RPE on FA, optic disc edema was observed in the active stage. Normal FAF was noted during the follow-up for 3 years on the patient.

Conclusions: : Increased FAF occurred during follow-up periods of VKH and may remain for a long term, probably due to increased accumulation of lipofuscin in the retinal pigment epithelium. Evaluation of FAF may be one useful noninvasive method to evaluate the pathological status of VKH.

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