title: Changes in Scleral Architecture in Chronic Vogt-Koyanagi-Harada Disease.
abstract: OBJECTIVE
  To describe scleral changes in chronic VKH.
  
  
  METHODS
  Medical records of patients with chronic VKH were retrospectively reviewed. Change of scleral architecture was defined as progressive posterior bowing on OCT, axial length elongation, and/or increased myopia more than -1.0 D, not explicable by other etiologies.
  
  
  RESULTS
  In total, 28 eyes (16 patients) with mean age of disease onset 32.5 ± 14.0 years were included in the study. Disease duration was 15.1 ± 10.2 years. Eight eyes (28.6%) showed progressive scleral architectural changes. Five eyes (18%) developed scleral changes on OCT, not seen on prior imaging (2-12 years earlier). One eye had posterior bowing on OCT with increased axial length, both eyes of a bilateral pseudophake developed increased myopia with increased axial length. Well-circumscribed chorioretinal atrophy within the arcade was associated with progressive scleral change.
  
  
  CONCLUSIONS
  Progressive scleral change may develop as a late complication of VKH. The association with well-circumscribed chorioretinal atrophy suggests that chronic choroidal inflammation may be responsible.
authors.affiliation: a Department of Ophthalmology , Northwestern University, Feinberg School of Medicine , Chicago , Illinois , USA.|b Department of Ophthalmology , Kochi Medical School , Kochi , Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Harada
authors.affiliation: a Department of Ophthalmology , Northwestern University, Feinberg School of Medicine , Chicago , Illinois , USA.|c Department of Ophthalmology and Visual Sciences , University of Illinois at Chicago , Illinois , USA.
authors.forename: Pooja
authors.initials: P
authors.lastname: Bhat
authors.affiliation: a Department of Ophthalmology , Northwestern University, Feinberg School of Medicine , Chicago , Illinois , USA.|d Department of Ophthalmology, Inselspital , University Hospital Bern , Switzerland.
authors.forename: Marion R
authors.initials: MR
authors.lastname: Munk
authors.affiliation: a Department of Ophthalmology , Northwestern University, Feinberg School of Medicine , Chicago , Illinois , USA.
authors.forename: Debra A
authors.initials: DA
authors.lastname: Goldstein
mesh_terms: D000293:Adolescent; D000328:Adult; D058452:Axial Length, Eye / Q000473:pathology*; D002648:Child; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D015422:Scleral Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D041623:Tomography, Optical Coherence; D014607:Uveomeningoencephalitic Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D007166:Immunosuppressive Agents
keywords: OCT; VKH; choroid; sclera; uveitis