Macular OCT features in eyes with VKH disease

Abstract

PurposeTo describe choroidal and retinal patterns evaluated with SD‐OCT in patients with Vogt‐Koyanagi‐Harada (VKH) disease.MethodsWe included all patients with VKH disease according to the international workshop on VKH and referred to Pitie‐Salpetriere Hospital between December 2014 and June 2015, for whom SD‐OCT was performed. Data collection consists of assessing the best corrected visual acuity (BCVA), the dosages of corticosteroids and immunosuppressors as well as the description of retinal and choroidal thickness and architecture.ResultsThirty eyes of 15 patients, 12 females and 3 males, with an average age of 44.5 years were included. The main uveitis follow‐up was 7.1 years. Two thirds of uveitis cases were chronic. The mean VA was 0.42 logMar. OCT features were macular edema (16.7%), external limiting membrane disruption (36.7%), atrophy of nuclear layers (13.3%), ellipsoid line disruption (36.7%), retinal pigment epithelial hyperplasia and atrophy (26.7% and 16.7%), serous retinal detachment (16.7%), choroidal folds (13.7%), Sattler's and Haller's layers disorganisation (60% and 43%). Retinal and choroidal thicknesses were 259.3 μ and 325.1 μ respectively. The proportion of eyes with ellipsoid disruption, pigment epithelium atrophy and alterations of choroidal layers was more important in the group of eyes with VA superior or equal to 0.4 logMar. Uveitis duration in the first group was superior compared to the second group (5.2 vs. 11.2 years). The degree of inflammation, based on laser flare meter values, was similar.ConclusionsSevere retinal damages seem not to be so common and are frequently associated with poor visual acuity. Haller and Sattler layers alteration are common in acute and chronic cases of VKH disease. Starting rapidly corticosteroid treatment or/and immunosupressors is necessary to avoid these irreversible damages.