VASCULAR CHANGES AND IRREVERSIBLE COMPLICATIONS IN 120° FUNDUS USING WIDEFIELD SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN VOGT-KOYANAGI-HARADA DISEASE.

Abstract

To characterize the changes in fundus corresponding to 120° field of view in chronic Vogt-Koyanagi-Harada disease in the quiescent phase and explore the associations with irreversible complications in the fundus using widefield swept-source optical coherence tomography angiography. Prospective cross-sectional study. Sixty-nine patients with chronic Vogt-Koyanagi-Harada disease (115 eyes) and 55 healthy control subjects (110 eyes) were included and underwent widefield swept-source optical coherence tomography angiography. Univariate analyses of variations in retinal and choroidal vessel density (VD), choroidal volume, and choroidal vascularity index in patients with Vogt-Koyanagi-Harada with different disease durations and the control subjects were conducted. Logistic regression analysis was used to identify the associations with irreversible complications, including choroidal neovascularization, vasoproliferative tumor of the retina, and chorioretinal atrophy. The Welch analysis of variance showed lower VD of superficial retina, deep retina, choriocapillaris, and large-sized and medium-sized vessels of the choroid, and choroidal volume and choroidal vascularity index in the patients with disease duration of >24 months compared with those with disease duration of ≤24 months (all P ≤ 0.011). The regression analysis revealed that the disease duration ( P = 0.008; OR = 1.02, 95% CI, 1.005-1.035) and VD of large-sized and medium-sized vessels of the choroid ( P = 0.001; OR = 0.707, 95% CI, 0.575-0.87) were significantly correlated with the irreversible complications. Patients with chronic Vogt-Koyanagi-Harada in the quiescent phase with disease duration of >24 months exhibit more severe decreased VD in each layer of the retina and choroid, reduced choroidal volume, and sparse choroidal vascularity compared with those with disease duration ≤24 months. Prolonged duration and decreased VD of large-sized and medium-sized vessels of the choroid were associated with irreversible complications in the fundus.