Choroidal and Retinal Anatomical Responses Following Systemic Corticosteroid Therapy in Vogt-Koyanagi-Harada Disease Using Swept-Source Optical Coherence Tomography

Ocul Immunol Inflamm. 2019;27(2):235-243. doi: 10.1080/09273948.2017.1332231. Epub 2017 Jul 12.

Abstract

Purpose: To assess structural changes in retina and choroid after systemic corticosteroid therapy in Vogt-Koyanagi-Harada (VKH) disease using swept-source optical coherence tomography (SS-OCT).

Methods: SS-OCT was conducted before treatment and during first-month follow-up in 16 eyes treated with systemic corticosteroids for active VKH. Retina was divided into five zones depending on pretreatment choroidal thickness (CT) of <100, >100 to <200, >200 to <300, >300 to <400 and >400μm, and changes in retinal thickness and CT after treatment in these zones were compared with baseline.

Results: Mean CT significantly improved from 83.1±8.75 to 156.4±62.73μm(p = 0.008) in the zone with pre-CT <100μm and significantly decreased from 336.1 ± 17.28 to 266.28 ± 81.39μm(p = 0.008) in the zone with pre-CT > 300μm.

Conclusions: We have shown choroidal remodeling in VKH. SS-OCT can serve as an important noninvasive tool in assessment of treatment response in patients with VKH disease.

Keywords: Choroidal and retinal thicknesses; Vogt–Koyanagi–Harada disease; choroidal vascularity index; swept- source optical coherence tomography; systemic steroid response.

MeSH terms

  • Adolescent
  • Adult
  • Choroid / drug effects
  • Choroid / pathology*
  • Female
  • Follow-Up Studies
  • Glucocorticoids / therapeutic use
  • Humans
  • Male
  • Methylprednisolone / therapeutic use*
  • Middle Aged
  • Retina / pathology*
  • Retrospective Studies
  • Tomography, Optical Coherence / methods*
  • Uveomeningoencephalitic Syndrome / diagnosis*
  • Uveomeningoencephalitic Syndrome / drug therapy
  • Visual Acuity*
  • Young Adult

Substances

  • Glucocorticoids
  • Methylprednisolone