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Ultra-wide-field angiography findings in acute Vogt-Koyanagi-Harada disease
  1. Patrick Kim,
  2. Hae Jung Sun,
  3. Don-Il Ham
  1. Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
  1. Correspondence to Professor Don-Il Ham, Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; oculus{at}


Background/aims To investigate the prevalence of abnormal central and peripheral ultra-wide-field (UWF) angiography findings, and their association with clinical features in acute Vogt-Koyanagi-Harada (VKH) disease.

Methods This retrospective, observational study included 26 eyes of 13 treatment-naïve patients with acute VKH disease who underwent UWF fluorescein angiography (FA). Sixteen eyes of eight patients also underwent UWF indocyanine green angiography (ICGA). A circle simulating the central 75° field was used to divide the acquired image into the central fundus area (CFA) and peripheral fundus area (PFA), in which the presence of six previously reported abnormal angiographic findings were analysed. Correlations between abnormal angiography findings in FA and clinical features were also investigated.

Results All eyes demonstrated more than one abnormal angiographic finding in both the CFA and PFA. UWF FA revealed three abnormal findings in the CFA versus the PFA: focal leakage (92.3% vs 76.9%); pooling with a dark rim (84.6% vs 53.8%); and retinal vascular leakage (0% vs 46.2%). UWF ICGA revealed three abnormal findings in the CFA versus the PFA: hypofluorescent dark dots (100% vs 100%); diffusely leaking fuzzy choroidal vessels (93.8% vs 75.0%); and late hypofluorescent patches (81.3% vs 31.3%). Pooling with a dark rim and retinal vascular leakage in the PFA were significantly associated with low initial visual acuity (p=0.03) and subfoveal choroidal thickness change ratio (p=0.04), respectively.

Conclusion Abnormal UWF angiography findings were frequently detected in the CFA and PFA. Such findings may be useful in evaluation and monitoring of VKH disease.

  • inflammation
  • imaging
  • retina
  • choroid

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  • Contributors PK: design of the work, data collection, data analysis and interpretation, drafting the article. HJS: data analysis and interpretation, critical revision of the article. DIH: design of the work, data analysis and interpretation, critical revision and final approval of the article to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Institutional review board approval was obtained by the Samsung Medical Center, and the study was performed in accordance with the principles of the Declaration of Helsinki.

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

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