Choroidal thickening prior to anterior recurrence in patients with Vogt-Koyanagi-Harada disease.
OBJECTIVE
To assess choroidal thickness changes associated with anterior segment recurrences in patients with Vogt-Koyanagi-Harada (VKH) disease using enhanced depth imaging optical coherence tomography (EDI-OCT).


METHODS
EDI-OCT images were obtained periodically from 11 patients with VKH disease (22 eyes) who were followed-up due to anterior segment recurrences. Subfoveal choroidal thickness (SCT) values at the following stages were evaluated: (1) during the remission phase, (2) 1 month before detecting the anterior recurrence, (3) during the anterior recurrence and (4) after systemic prednisolone (PSL) treatment leading to remission. In comparison with SCT values in remission as baseline, the changing ratios of SCT were statistically analysed at subsequent three stages.


RESULTS
The average of the SCT changing ratios compared with the remission phase significantly increased to 1.45±0.11 during anterior segment recurrences (p=0.00044) lacking any funduscopic signs of posterior involvement. Interestingly, the average SCT ratio 1 month before detecting the recurrence had already increased to 1.30±0.08 (p=0.002). After the PSL treatment, the ratio of SCT recovered to 0.95±0.03, which was equivalent to the remission level. However, in patients with their remission SCT values less than 240 µm, the SCT ratio did not increase significantly at any time points evaluated.


CONCLUSIONS
The choroid in eyes with VKH disease thickened in association with the anterior segment recurrence, and this thickening was observed prior to the recurrence. EDI-OCT may be useful for detecting latent choroidal inflammation in VKH disease, whereas it may not for patients with the relatively thin choroid.


BACKGROUND
The trial registration number of the internal review board of Hokkaido University Hospital is 014-0384.
Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Yoshiaki
Y
Tagawa
Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Kenichi
K
Namba
Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Kazuomi
K
Mizuuchi
Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Yuko
Y
Takemoto
Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Daiju
D
Iwata
Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Tomoe
T
Uno
Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Takako
T
Fukuhara
Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Kiriko
K
Hirooka
Department of Ophthalmology, Health Sciences University of Hokkaido, Sapporo, Japan.
Nobuyoshi
N
Kitaichi
Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Shigeaki
S
Ohno
Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Susumu
S
Ishida
D000293:Adolescent; D000328:Adult; D000869:Anterior Eye Segment / Q000473:pathology*; D002648:Child; D002829:Choroid / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011239:Prednisolone / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014607:Uveomeningoencephalitic Syndrome / Q000175:diagnosis* / Q000188:drug therapy
D005938:Glucocorticoids; D011239:Prednisolone
Choroid; Imaging; Inflammation