Our data suggest that circulatory disturbances and increased thickness of the choroid relate to the pathogenesis of VKH disease with link mutually. LSFG is useful as an index for evaluating the choroiditis activity of VKH disease as well as EDI-OCT.
Sub-title:Choroidal thickening was detected in the anterior segment recurrence of Vogt-Koyanagi-Harada disease by enhanced depth imaging optical coherence tomography, and this thickening was observed prior to the recurrence.
ABSTRACTAim To assess choroidal thickness changes associated with anterior segment recurrences in patients with Vogt-Koyanagi-Harada (VKH) disease using enhanced depth imaging optical coherence tomography (EDI-OCT).Methods EDI-OCT images were obtained periodically from 11 VKH disease patients (22 eyes) who were followed-up due to anterior segment recurrences.Subfoveal choroidal thickness (SCT) values at the following stages were evaluated: (1) during the remission phase, (2) one month before detecting the anterior recurrence, (3) during the anterior recurrence, and (4) after systemic prednisolone (PSL) treatment leading to remission. In comparison with SCT values in remission as baseline, the changing ratios of SCT were statistically analyzed at subsequent three stages.
ResultsThe average of the SCT changing ratios compared to the remission phase significantly increased to 1.45 ± 0.11 during anterior segment recurrences (P=0.00044) lacking any funduscopic signs of posterior involvement. Interestingly, the average SCT ratio one month before detecting the recurrence had already increased to 1.30 ± 0.08 (P=0.002). After the PSL treatment, the ratio of SCT recovered to 0.95 ± 0.03 which 3 was equivalent with the remission level. However, in patients with their remission SCT values less than 240 µm, the SCT ratio did not increase significantly at any time points evaluated.
These results reveal that there is a significant elevation of choroidal blood flow velocity and substantial reduction of choroidal thickness with regression of UAIM, suggesting that impaired choroidal circulation may be involved in the pathogenesis of UAIM.
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