Indocyanine green angiographic findings of Dalen-Fuchs nodules in Vogt-Koyanagi-Harada disease.
OBJECTIVE
The purpose of this study was to analyze indocyanine green (ICG) angiographic findings of Dalen-Fuchs nodules in Vogt-Koyanagi-Harada (VKH) disease.


METHODS
ICG angiograms of 15 patients (30 eyes) with Dalen-Fuchs nodules in VKH disease of between 2 months and 5 years after the initial diagnosis were retrospectively studied. Findings of ICG angiography were compared with features of fundus fluorescein angiography (FFA).


RESULTS
Dalen-Fuchs nodules were easily found in the inferior (30 eyes, 100%) and temporal periphery (22 eyes, 73%) and showed two kinds of fluorescence in ICG angiography. In ten patients (20 eyes), the nodules showed small round hypofluorescent dark dots in the whole process of angiography, and the dark dots were larger in size than the nodules in FFA. Disease course in these patients was relatively long-between 1 year and 5 years. On clinical examination, the nodules were atrophic, and hyperpigmentation was found around them. In another five patients (ten eyes), parts of the nodules showed small hyperfluorescent dots in the early phase, but they were faint in the intermediate phase and became large, hypofluorescent dark dots in the late phase. Disease course in these patients was between 2 and 8 months. The nodules were bright yellow, fresh, and much larger than those in the first kind of ICG fluorescence.


CONCLUSIONS
Dalen-Fuchs nodules in VKH are mostly present in the inferior and temporal periphery. The two kinds of fluorescence of Dalen-Fuchs in ICG angiography may reflect obliteration of choriocapillaris under the nodules and different quantities of lipofuscin in the nodules at different time points of the disease.
Wu
Weiju
W
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 Xianlie Road, Guangzhou 510060, People's Republic of China.
Wen
Feng
F
Huang
Shizhou
S
Luo
Guangwei
G
Wu
Dezheng
D
D000328:Adult; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D006099:Granuloma / Q000175:diagnosis*; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D010857:Pigment Epithelium of Eye / Q000473:pathology; D012164:Retinal Diseases / Q000175:diagnosis*; D012189:Retrospective Studies; D014607:Uveomeningoencephalitic Syndrome / Q000175:diagnosis*
D004396:Coloring Agents; D007208:Indocyanine Green