The role of enhanced depth imaging optical coherence tomography in chronic Vogt-Koyanagi-Harada disease.

Abstract

To determine the role of enhanced depth imaging optical coherence tomography (EDI-OCT) in chronic Vogt-Koyanagi-Harada (VKH) disease. Records of all consecutive patients with VKH seen at the Singapore National Eye Centre were retrospectively reviewed for concurrent EDI-OCT and indocyanine green angiograms (ICGAs) obtained six or more months after disease onset, demographics and duration of disease. The ICGAs were scored based on the following signs: early choroidal stromal vessel hyperfluorescence and leakage, hypofluorescent dark dots, fuzzy vascular pattern of large stromal vessels and disc hyperfluorescence, and correlated with the subfoveal choroidal thickness (SFCT) measured using EDI-OCT. Only images of one eye were analysed. 105 pairs of EDI-OCT and ICGA of 52 patients were included. Mean age was 51.7 years. Half of the patients (26) were male and the majority were Chinese (39 patients, 75.0%). Mean duration of disease was 106.3 months. There were 79 ICGA active episodes. Mean SFCT was thinner when ICGA was quiet (mean=187.31 μ), than when the ICGA was active (mean=272.38 μ, p=0.002). There was a positive correlation of the SFCT with the ICGA score but a negative correlation with age and duration of disease. Multivariate analysis showed that age, duration of disease and ICGA were the main factors affecting SFCT. The positive correlation of SFCT measurements with ICGA score suggests that it may be used to monitor disease activity in chronic VKH in addition to ICGA, possibly reducing the number of ICGAs required.