First Author: K.Hashizume JAPAN
Co Author(s): Y. Imamura Y. Nishida T. Fujiwara S. Machida M. Ishida D. Kurosaka
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To evaluate the changes in the choroidal large vascular layer after steroid therapy for Vogt–Koyanagi–Harada (VKH) disease.
Retrospective, interventional case series.
This retrospective study included 52 eyes of 26 patients with acute VKH disease, who received treatment at Iwate Medical University Hospital (Morioka, Japan) between January 2012 and December 2015. Initial treatment involved steroid pulse therapy, followed by oral prednisolone tapering. Enhanced-depth imaging–optical coherence tomography (EDI–OCT) images of the macular area acquired during the clinical course were analysed by Photoshop Creative Cloud to evaluate the intensities of the choroidal large vascular layer before and at 1 and 3 months after treatment, and thus determine the changes in intensity.
The mean age of the patients was 47.8 ± 16.6. (14 females). The mean interval after the onset before steroid pulse therapy was 47.8 ± 16.6 days. Serous retinal detachment was observed in 45 eyes of 26 patients. The intensities of the choroidal large vascular layer before, at 1 month and 3 months after treatment were 32 ± 13, 54 ± 19 (p 0.001, Sheffe’s test), and 58 ± 23 (p 0.001, Sheffe’s test), respectively, which indicated significant increases after the initiation of treatment.
In patients with acute VKH disease, EDI–OCT findings revealed a marked decrease in the intensity of the choroidal large vascular layer. This result suggests that the intensity of the choroidal large vascular layer might serve as an indicator for the severity of inflammation in VKH disease, and may be a hallmark of cellular infiltration of the choroid.