Session Title: Imaging II
Session Date/Time: Friday 18/09/2015 | 16:30-18:00
Paper Time: 17:26
First Author: : Y.Imamura JAPAN
Co Author(s): : K. Hashizume T. Fujiwara S. Machida M. Ishida D. Kurosaka
PURPOSE:To determine the possible correlation of retinal pigment epithelium undulations and persistent presence of serous retinal detachment (SRD) in the acute stage of Vogt-Koyanagi-Harada (VKH) disease after high-dose steroid therapy .
Retrospective interventional case series
The medical records of patients with acute VKH disease were retrospectively reviewed. All of the eyes were treated with intravenous high-dose steroid therapy and examined with the Heidelberg Spectralis OCT with eye tracking and image averaging systems to obtain choroidal images. The height of SRD and choroidal thickness were measured before and after high-dose steroid therapy. The undulations of RPE were defined as the wavy protrusion of RPE cell line seen in enhanced depth imaging OCT(EDI-OCT) image. In order to scale them, we classified them into 3 grading scales: grade 1: slight undulations, grade 2: moderate undulations, grade 3: severe undulations. The choroidal thickness was measured with the EDI-OCT technique. When the choroidal thickness was more than 1000 µm or the outer border of the choroid was unclear, we designated the thickness as 1000 µm.
Sixty-six eyes of 33 VKH patients (mean age: 48.9 years, 22 females) were included, and 58 eyes had SRD before the initial steroid therapy. The height of SRD before the initial steroid therapy was strongly correlated with choroidal thickness at baseline (Spearman’s rank correlation coefficient: r=0.450, P= 0.001). Multiple regression analysis revealed that increased choroidal thickness at baseline was an independent predictor of high SRD (P = 0.041) and poor visual acuity before steroid therapy (P= 0.029). The higher grade of RPE undulations at baseline was an independent predictor of persistent SRD (P= 0.001).
The presence of RPE undulations appears to be a possible risk factor of persistent SRD after high-dose steroid therapy. RPE undulation may be a consequence of severe choroidal inflammation and would be a biomarker for outcomes after the therapy.