Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 1;42(9):1788-1795.
doi: 10.1097/IAE.0000000000003525.

OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY REVEALS PARADOXICALLY DECREASING CHOROIDAL THICKNESS AND INCREASING BLOOD FLOW IN REMITTING VOGT-KOYANAGI-HARADA SYNDROME

Alaa E Fayed  1   2 , Terese K Gerges  2
Affiliations

OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY REVEALS PARADOXICALLY DECREASING CHOROIDAL THICKNESS AND INCREASING BLOOD FLOW IN REMITTING VOGT-KOYANAGI-HARADA SYNDROME

Alaa E Fayed et al. Retina. .

Abstract

Purpose: To assess changes in choroidal thickness and blood flow in active Vogt-Koyanagi-Harada syndrome and after remission using optical coherence tomography angiography.

Methods: This was a prospective study of patients with active early uveitis secondary to Vogt-Koyanagi-Harada syndrome. They underwent optical coherence tomography angiography imaging twice: at baseline and after remission on treatment. 3- × 3- and 6- × 6-mm choriocapillaris slabs were used to evaluate parafoveal adjusted flow index as a marker for choroidal blood flow. Mean choroidal thickness of 3 points (subfoveally and 2 points 300 µ m parafoveally) was also measured.

Results: Thirty-nine eyes of 25 patients were initially recruited. After excluding eyes with media opacity, submacular fibrosis, and choroidal neovascularization, 23 eyes of 14 patients were included. The mean follow-up period was 8.7 ± 2.5 months. Mean choroidal thickness in activity and remission was 581.65 ± 108.29 µ m and 318.34 ± 72.85 µ m respectively ( P < 0.01). Mean adjusted flow index in the 3- × 3-mm slabs activity and remission were 0.495 ± 0.027 and 0.519 ± 0.0336 ( P = 0.011), and the 6- × 6-mm slabs were 0.487 ± 0.037 and 0.517 ± 0.052 respectively ( P = 0.025).

Conclusion: We demonstrate decreasing choroidal thickness with paradoxically increasing choroidal flow on optical coherence tomography angiography in remitting Vogt-Koyanagi-Harada syndrome. This may reflect inflammatory infiltrations or granulomas increasing choroidal thickness during activity and causing sluggish circulation of the choriocapillaris, and a reversal of this process with remission. These findings shed more light on the relationship between Vogt Koyanagi Harada syndrome and its underlying choroidal disturbances. Larger studies are needed to evaluate the efficacy of adjusted flow index in evaluating and predicting disease activity.

PubMed Disclaimer

References

    1. Moorthy RS, Inomata H, Rao NA. Vogt-koyanagi-harada syndrome. Surv Ophthalmol 1995;39:265–292.
    1. Read RW, Holland GN, Rao NA, et al. Revised diagnostic criteria for Vogt-Koyanagi-Harada disease: report of an international committee on nomenclature. Am J Ophthalmol 2001;131:647–652.
    1. Stanga PE, Lim JI, Hamilton P. Indocyanine green angiography in chorioretinal diseases: indications and interpretation: an evidence-based update. Ophthalmology 2003;110:15–23.
    1. Bouchenaki N, Herbort CP. The contribution of indocyanine green angiography to the appraisal and management of Vogt-Koyanagi-Harada disease. Ophthalmology 2001;108:54–64.
    1. Herbort CP, Mantovani A, Bouchenaki N. Indocyanine green angiography in Vogt–Koyanagi–Harada disease: angiographic signs and utility in patient follow-up. Int Ophthalmol 2007;27:173–182.

MeSH terms

LinkOut - more resources