Abstract

Purpose. To characterize the optical coherence tomography (OCT) findings in late-stage Vogt-Koyanagi-Harada (VKH) disease and its correlation with visual function. Methods. The records of patients with late-stage VKH disease (defined as ≥12 months from disease onset) were retrospectively reviewed. The analysis focused on the OCT findings and microperimetry, in addition to the possible correlation between morphology and functional findings. Results. Twenty-nine patients (58 eyes) were included. Mean age at onset was 34.24 ± 10.67 years. The OCT revealed that the outer retina and retinal pigment epithelium (RPE) were mainly affected. These effects included RPE thickening and breakage or disappearance of the cone outer segment tip (COST) line and/or inner segment/outer segment (IS/OS) junction. The COST line and IS/OS results were related to macular function and the interval between symptom onset and initiation of high-dose corticosteroid treatment (all P < 0.01). Eyes with intact COST lines demonstrated intact IS/OS and normal RPE layers as well as better visual function and normal retinal sensitivity. Conclusions. The OCT findings are strongly correlated with macular function, as well as other clinical findings in late-stage VKH. With respect to the COST line and retinal sensitivity especially, the OCT and microperimetry findings may be useful for evaluating later-stage VKH.

Highlights

  • Vogt-Koyanagi-Harada disease (VKH) is a granulomatous inflammatory disorder affecting the eyes, auditory system, meninges, and skin [1, 2]

  • We investigated the characteristics of late-stage VKH via optical coherence tomography (OCT), especially photoreceptor microstructure integrity and its potential correlation to visual function

  • Our analysis revealed a strong correlation between retinal sensitivity/best corrected visual acuity (BCVA) and the OCT findings of the cone outer segment tips (COST) line, inner segment/outer segment (IS/OS) junction, and retinal pigment epithelium (RPE) layer

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Summary

Introduction

Vogt-Koyanagi-Harada disease (VKH) is a granulomatous inflammatory disorder affecting the eyes, auditory system, meninges, and skin [1, 2]. It is one of the most common causes of uveitis in Asia and accounts for approximately 16% of all uveitis cases in China [3]. Recent studies report a significant association of the inner segment (IS)/OS junction and the cone outer segment tips (COST) line in various retinal diseases with visual function [11,12,13]. Microperimetry was found to provide a more comprehensive assessment of macular sensitivity and functional changes in the macula [14, 15]

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