Contribution of dual fluorescein and indocyanine green angiography to the appraisal of posterior involvement in birdshot retinochoroiditis and Vogt‐Koyanagi‐Harada disease

Abstract

PurposeTo assess the levels of retinal versus choroid involvement in two stromal choroiditis entities, birdshot retinochoroiditis (BRC) and Vogt‐Koyanagi‐Harada (VKH) disease in initial onset non treated disease.MethodsThis retrospective study included patients diagnosed with BRC and VKH, seen during initial onset disease at the Centre for Ophthalmic Specialized Care, Lausanne, Switzerland. Angiographic signs were quantified, using an established dual FA and ICGA scoring system for uveitis, and the FA/ICGA ratios were compared between diseases.ResultsAmong 1,739 patients with uveitis seen from 1995 to 2014, 7 newly diagnosed BRC patients and 4 patients with newly diagnosed VKH disease were included in the study. Patients with BRC and VKH had mean FA angiographic scores of 16.64 ± 3.75 and 4.25 ± 1.83; mean ICGA angiographic scores of 21.00 ± 3.48 and 25.25 ± 3.84; and mean FA/ICGA ratios of 0.79 ± 0.21 and 0.17 ± 0.09, respectively.ConclusionsThis study showed the differential involvements of the retina and choroid in BRC and VKH. Choroid was predominantly involved in both diseases, which clearly indicated that ICGA was the method of choice, and that it should be performed in conjunction with FA. Also, the FA/ICGA ratio highlighted the fundamental differences between BRC and VKH. VKH had a purely choroidal origin of inflammation, and BRC had both retinal and choroidal origins of inflammation.