Retinal vasculitis (RV) in acute and non-acute Vogt-Koyanagi-Harada disease (VKHD): a cross-sectional study with multimodal analysis

Abstract

Purpose : To evaluate the characteristics of RV and its association with other inflammatory signs and visual function in patients with VKHD

Methods : Retrospective, cross-sectional and descriptive study with patients with VKHD followed for a minimum 2 years from disease acute onset with predefined treatment protocols. Inflammation was systematically evaluated with clinical and posterior segment imaging exams (fluorescein and indocyanine green angiographies, enhanced depth imaging optical coherence tomography). RV was defined angiographically as perivascular leakage and/or hyperfluorescence of the vessel wall. The presentation of RV was divided into acute phase (≤6 mo), non-acute phase (> 6 mo) or both phases. The location of the RV was classified as posterior pole, peripheral or both locations. To assess visual function, a full-field electroretinogram (ffERG) was performed at enrollment and at predefined intervals. Medians and range were calculated for descriptive analysis. Data were analyzed using generalized estimated equations for binary ocular data, Bonferroni correction for multiple comparison, likelihood ratio and Fisher exact tests; p-values≤ 0.05 were considered statistically significant. This study was approved by Institutional Ethics Committee and followed Helsinki declaration

Results : Fifty-four eyes (27 patients) were evaluated. Thirty eyes (55%) had RV signs; among them 16 eyes (53%) presented RV in both phases, 11 eyes (36%) only in the non-acute phase and 3 eyes only in the acute phase. Among the 16 eyes with RV in both phases, 4 eyes (25%) were localized both in the posterior pole and periphery. Relation between RV and inflammatory signs or ffERG results was not observed. On the opposite way, it was related to thinner subfoveal choroidal thickness (SFCT) (p<0.001) and lower incidence of choroidal neovascularization (CNV) (p=0.044). However, when analyzing disease different phases and RV location, RV in the non-acute phase (p=0.007) and involving periphery (p=0.031) was related with thicker SFCT at month 1. Higher incidence of CNV (p=0.024) was observed in eyes with RV in posterior pole (Table)

Conclusions : Although there are few descriptions in the literature, RV in VKHD seems not to be an unusual finding. RV in different phases and locations seems to have different implications

This is a 2020 ARVO Annual Meeting abstract.

 

Table

 

Retinal vasculitis in patients with VKHD and its location