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Changes of choroidal structure after corticosteroid treatment in eyes with Vogt–Koyanagi–Harada disease
  1. Mariko Egawa1,
  2. Yoshinori Mitamura1,
  3. Kei Akaiwa1,
  4. Kentaro Semba1,
  5. Takamasa Kinoshita1,
  6. Eisuke Uchino2,
  7. Shozo Sonoda2,
  8. Taiji Sakamoto2
  1. 1Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
  2. 2Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
  1. Correspondence to Professor Yoshinori Mitamura, Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan; ymitaymitaymita{at}yahoo.co.jp

Abstract

Aims To report the changes of the choroidal structure in the enhanced depth imaging optical coherence tomographic (EDI-OCT) images after high-dose corticosteroid treatment for acute Vogt–Koyanagi–Harada (VKH) disease.

Methods Retrospective, observational case series. Thirty-four eyes of 17 patients with acute VKH disease were examined by EDI-OCT before, and 1, 4 and 52 weeks after the treatment. The EDI-OCT images were binarised by ImageJ, a publicly accessible software. The luminal, stromal and total choroidal areas and ratio of luminal/stromal area (L/S ratio) were measured in the subfoveal choroid of 1500 µm width. The area of the peripapillary atrophy (PPA) was measured in the fundus photographs at 1 and 52 weeks. For statistical analyses, a generalised estimating equation method was used to eliminate the effect of within-subject intereye correlations.

Results Before treatment, the EDI-OCT images could not be binarised because of poor image quality in most of the cases. After treatment, the luminal, stromal and total choroidal areas were significantly decreased during the follow-up period (all p<0.05). The L/S ratio significantly fluctuated over time (p=0.0201), and was significantly lower at 4 weeks than at 1 week (p=0.0158). The L/S ratio at 1 week was significantly correlated with increase in the PPA area, subsequent chronic recurrences and total dose of corticosteroid (p<0.0001, p=0.0006, p=0.0037, respectively).

Conclusions The L/S ratio measured by binarisation of EDI-OCT images was predictive factor for the progression of PPA, subsequent chronic recurrences and total dose of corticosteroid, and may serve as a marker for degree of choroidal inflammation in the VKH disease.

  • Choroid
  • Imaging
  • Inflammation
  • Treatment Medical

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Footnotes

  • Contributors All authors have given final approval of this version to be published. Design of the study (YM, SS and TS), conduct of the study and management of the data (ME, KA, KS and TK), analysis of the data (ME, YM, KA, KS, TK, EU and SS), interpretation of the data (ME, YM, EU, SS and TS), preparation of the manuscript (ME and YM) and overall coordination (TS).

  • Funding This work was supported in part by grant-in-aid 25462717 (to YM) from the Ministry of Education, Science, Sports and Culture, Japan.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The Institutional Review Board of Tokushima University Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are available from the corresponding author upon request.

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