PURPOSE: Optical coherence tomography (OCT) using enhanced depth imaging (EDI) allows evaluation of choroidal thickness. Our objective was to analyze subfoveal choroidal thickness by EDI-OCT before and after the initiation of high-dose corticosteroid treatment in 8 patients (16 eyes) with new-onset acute Vogt-Koyanagi-Harada (VKH) disease. METHODS: Retrospective review of clinical records. RESULTS: The outer border of the choroid was not evident by EDI-OCT in any patients at presentation. Subfoveal choroidal thickness was measurable by 1 week after the initiation of treatment (mean, 578 μm) and decreased thereafter (mean at 1 month, 397 μm; 3 months, 392 μm; 6 months, 384 μm; 12 months, 332 μm). Rebound of choroidal thickening was observed in three patients (five eyes) during corticosteroid tapering in the absence of other evidence of increased inflammation. Peripapillary atrophy was present at 12 months in 6 of 6 eyes that had a choroidal thickness >550 μm at 1 week after initiating treatment, in contrast to none of the 8 eyes with a choroidal thickness ≤550 μm (P = 0.0003). CONCLUSION: Enhanced depth imaging-optical coherence tomography revealed decreasing choroidal thickness with high-dose corticosteroid treatment in our patients. Choroidal thickness as measured by EDI-OCT may serve as a marker for degree of choroidal inflammation in acute VKH disease.
PURPOSE: Optical coherence tomography (OCT) using enhanced depth imaging (EDI) allows evaluation of choroidal thickness. Our objective was to analyze subfoveal choroidal thickness by EDI-OCT before and after the initiation of high-dose corticosteroid treatment in 8 patients (16 eyes) with new-onset acute Vogt-Koyanagi-Harada (VKH) disease. METHODS: Retrospective review of clinical records. RESULTS: The outer border of the choroid was not evident by EDI-OCT in any patients at presentation. Subfoveal choroidal thickness was measurable by 1 week after the initiation of treatment (mean, 578 μm) and decreased thereafter (mean at 1 month, 397 μm; 3 months, 392 μm; 6 months, 384 μm; 12 months, 332 μm). Rebound of choroidal thickening was observed in three patients (five eyes) during corticosteroid tapering in the absence of other evidence of increased inflammation. Peripapillary atrophy was present at 12 months in 6 of 6 eyes that had a choroidal thickness >550 μm at 1 week after initiating treatment, in contrast to none of the 8 eyes with a choroidal thickness ≤550 μm (P = 0.0003). CONCLUSION: Enhanced depth imaging-optical coherence tomography revealed decreasing choroidal thickness with high-dose corticosteroid treatment in our patients. Choroidal thickness as measured by EDI-OCT may serve as a marker for degree of choroidal inflammation in acute VKH disease.
Authors: Vivian S Vuong; Elad Moisseiev; David Cunefare; Sina Farsiu; Ala Moshiri; Glenn Yiu Journal: Am J Ophthalmol Date: 2016-06-23 Impact factor: 5.258