First Author: B.Jelliti TUNISIA
Co Author(s): R. Kahloun O. Kharrat A. Bouabana R. Messaoud S. Ben Yahia M. Khairallah 0 0 0 0 0 0 0 0 0
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To assess the role of multimodal imaging in the diagnosis of acute Vogt-Koyanagi-Harada (VKH) disease without clinically evident exudative retinal detachment (ERD).
Department of Ophthalmology, Fattouma Bourguiba University Hospital, Monastir, Tunisia
Thirty six eyes of 18 consecutive patients diagnosed with acute VKH disease without clinically evident ERD were included in this study. We retrospectively reviewed fundus color photography, optical coherence tomography (OCT), fluorescein angiography (FA), indocyanine green angiography (ICGA), and ultrasonography obtained at the initial visit.
Mean age was 39 years. Twelve (66.7%) were female. Clinical presentation was a panuveitis in 22 eyes (61%) and a posterior uveitis in 14 eyes (39%). Main fundus findings included optic disc swelling in 30 eyes (83%) and choroidal/retinal folds in 20 eyes (55%). OCT findings included multifocal folds of retinal pigment epithelium in 23 eyes (64%), and limited ERD in 18 eyes (50%). FA findings included delayed choroidal perfusion in at least one eye of all patients (100%), hyperfluorescent pinpoints without obvious subretinal pooling in 21 eyes (58%), and optic disc hyperfluorescence in 35 eyes (97%). ICGA findings included delayed choroidal perfusion in 24 eyes (67%), decrease in the number of large choroidal vessels in 36 eyes (100%), fuzzy choroidal vessels in 35 eyes (97%), and hypofluorescent dark dots in 28 eyes (78%). Ultrasonography showed diffuse, low to medium reflective choroidal thickening in all eyes.
A careful clinical examination combined with multimodal imaging approach, including OCT, FA, ICGA, and ultrasonography is mandatory for the early, definite diagnosis of acute VKH disease without clinically evident ERD.