Abstract
BackgroundWhich of the choroidal layers suffers the most extensive morphological changes during the course of Vogt–Koyanagi–Harada (VKH) disease is still unknown. The aim of this study was to investigate the relationship between total thickness and the thickness of inner or outer layers in the choroid during systemic corticosteroid therapy in patients with VKH disease.MethodsThis retrospective case series included 15 eyes of 10 patients with treatment-naïve VKH disease (4 men and 6 women; mean age, 41.4 ± 14.7 years) received systemic corticosteroid therapy. Whole, inner, and outer choroidal thickness was measured manually at 1 week and at 1 and 3 months after initiation of systemic corticosteroid therapy using enhanced depth imaging optical coherence tomography. The mean thickness values of the layers were compared at each stage.ResultsCompared with the 1-week baseline, the mean whole and outer choroidal layer thicknesses were significantly lower at 1 (P = 0.008 and 0.03, respectively) and 3 months (P = 0.008 and 0.02, respectively), whereas the inner layer did not significantly thin. Importantly, there was a significant positive correlation between the rates of change of whole and outer layer thickness from 1 week to 3 months (R = 0.9312, P < 0.0001), but not between the rates of whole and inner layer thickness changes.ConclusionsThe thinning of total choroidal thickness observed after treatment with corticosteroids strongly correlated with outer layer thinning, suggesting that the choroidal outer layer is the primary target in acute-stage VKH disease.
Highlights
Which of the choroidal layers suffers the most extensive morphological changes during the course of Vogt–Koyanagi–Harada (VKH) disease is still unknown
Vogt–Koyanagi–Harada (VKH) disease is a multisystemic disease that affects systemic tissues containing melanin [1]. This disease is characterized by panuveitis with serous retinal detachment (SRD) and an underlying circulation disorder in the choroid [2, 3], a tissue known as the primary target of the disease
Using laser speckle flowgraphy (LSFG), we found that choroidal blood flow velocity in Hirooka et al BMC Ophthalmology (2015) 15:181 tissues deeper than the choriocapillaris decreases in the acute stage of VKH disease [3, 8]
Summary
Which of the choroidal layers suffers the most extensive morphological changes during the course of Vogt–Koyanagi–Harada (VKH) disease is still unknown. The aim of this study was to investigate the relationship between total thickness and the thickness of inner or outer layers in the choroid during systemic corticosteroid therapy in patients with VKH disease. Vogt–Koyanagi–Harada (VKH) disease is a multisystemic disease that affects systemic tissues containing melanin [1]. In the eye, this disease is characterized by panuveitis with serous retinal detachment (SRD) and an underlying circulation disorder in the choroid [2, 3], a tissue known as the primary target of the disease. There are no reports of which layers of the choroid are mainly affected morphologically in acute VKH disease
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