Changes in choroidal imaging parameters following adalimumab therapy for refractory noninfectious uveitis

Nishisho, Ryuto; Kusuhara, Sentaro; Sotani, Noriyuki; Kim, Kyong Woo; Katsuyama-Yoshikawa, Atsuko; Matsumiya, Wataru; Akashi, Koichi; Morinobu, Akio; Nakamura, Makoto

doi:10.1007/s00417-020-05032-9

Cited by 5 publications

(4 citation statements)

References 31 publications

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“…A larger, multi-centered study of 96 non-infectious uveitis (including VKH) patients reported good anti-inflammatory outcomes [ 56 ]. Subfoveal choroidal thickness, which may be a helpful indicator of treatment response in VKH, was effectively reduced with an Ada regimen in a series of 33 eyes with refractory non-infectious uveitis (42% with VKH) [ 57 ]. Three cases of VKH refractory to corticosteroids and either cyclosporine [ 58 ] or methotrexate [ 59 ] were shown to respond well after shifting treatment to Ada.…”

Section: Literature Review Of Vkh Treatmentmentioning

confidence: 99%

Immunosuppressive therapy for Vogt-Koyanagi-Harada disease: a retrospective study and review of literature

Rahman

Artiaga

Bouras

et al. 2023

J Ophthal Inflamm Infect

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Background Vogt-Koyanagi-Harada (VKH) disease is an idiopathic autoimmune disease which targets melanin-containing tissues such as the uvea, meninges, ear and skin. This typically presents in the eye with acute findings of granulomatous anterior uveitis, diffuse choroidal thickening, multiple focal areas of sub-retinal fluid and, in severe cases, optic nerve involvement with bullous serous retinal detachment can occur. Early initiation of treatment has been advocated to prevent progression to the chronic stage of the disease, which can result to a sunset glow fundus with devastatingly poor visual outcome. Treatment is usually initiated with corticosteroids followed by an early introduction of immunosuppressive treatment (IMT) to achieve immediate response after disease presentation, although the choice of IMT for VKH can vary. Main Findings We conducted a retrospective case-series to investigate the management trend of treating VKH over a 20-year period. Twenty-six patients were included and we found a shift from steroid monotherapy to combined IMT/low-dose steroid for the management of acute initial-onset of VKH in the last 10 years. Our average time from diagnosis to initiation of IMT was 2.1 months. 81% (21 of 26 patients) of our patients treated with combined IMT/steroid were able to achieve disease stability with significant good visual outcome at 24 months (Median VApre-IMT = 0.3 Logmar vs VApost-IMT = 0.0 Logmar, p = 0.0001). MMF monotherapy was the most common IMT used and it was well-tolerated by our patients. Even so, 50% of our patients who were treated with MMF did not achieve disease control. We then performed a literature review to identify any IMT which could be superior in the treatment of VKH. We also share our experience (where applicable) on the various treatment options found from the literature review. Short conclusion Our study found that patients with VKH who were treated with combined IMT/low-dose steroids achieved significantly better visual improvement at 24 months compared to steroid monotherapy. We frequently chose MMF and this appears to be well tolerated by our patients. Since its introduction, anti-TNF agents are increasingly becoming a popular choice of treatment for VKH as these have been shown to be safe and effective. However, more data is required to provide evidence that anti-TNF agents can be used as first-line treatment and as monotherapy.

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Section: Literature Review Of Vkh Treatmentmentioning

confidence: 99%

Immunosuppressive therapy for Vogt-Koyanagi-Harada disease: a retrospective study and review of literature

Rahman

Artiaga

Bouras

et al. 2023

J Ophthal Inflamm Infect

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“…The choroidal thickness has been proposed as an important inflammatory biomarker in some forms of uveitis. [31][32][33][34] However, the majority of articles referring to choroidal thickness in uveitis use manual segmentation to calculate the thickness. [35][36][37] Apart from choroidal thickness, an effort has been made to measure the flow attenuation and the vascularity at the level of the choroid.…”

Section: Quantification Of Choroidal Inflammationmentioning

confidence: 99%

Artificial Intelligence and Imaging Processing in Optical Coherence Tomography and Digital Images in Uveitis

Abellanas

Elena

Keane

et al. 2022

Ocular Immunology and Inflammation

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Computer vision, understanded as the area of science that trains computer to interpret digital images through both artificial intelligence (AI) and classical algorithms, has significantly advanced the analysis and interpretation of optical coherence tomography (OCT) in retina research. Its development to assist uveitis diagnosis and prognosis is still undergoing, but important efforts have been made in the field. The automatising of image processing in uveitis could be fundamental to establish objective and standardised outcomes for future clinical trials . In addition, it could help to better understand the disease and its progression. The aim of this review is to summarise the recent advances of computer vision in imaging processing in uveitis, with a particular focus in optical coherence tomography images.

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“…It can be differentiated into three layers: the choriocapillaris, the Sattler and the Haller layers, with increasing vessel diameters from the inside to the outside [2]. In the last few years, several authors have suggested a possible relationship between choroidal changes and degenerative or inflammatory ocular diseases, such as polypoidal choroidal vasculopathy (PCV) [3][4][5], exudative and non-exudative age-related macular degeneration (AMD) [6][7][8][9][10], high myopia [11][12][13] and intermediate uveitis [14][15][16], respectively, and the treatment of these illnesses [16][17][18][19][20][21][22]. The possible relationship between choroid and respiratory or cardiovascular disorders, such as obstructive sleep apnea syndrome [23,24] and atherosclerosis requiring carotid stenting [25,26], was also studied in depth.…”

Section: Introductionmentioning

confidence: 99%

Impact of Brightness on Choroidal Vascularity Index

Rosa,

Gioia,

Orlando

et al. 2024

JCM

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The use of choroidal vascularization to diagnose and follow-up ocular and systemic pathologies has been consolidated in recent research. Unfortunately, the choroidal parameters can be different depending on the lighting settings of optical coherence tomography (OCT) images. The purpose of this study was to examine whether the brightness of OCT images could influence the measurements of choroidal parameters obtained by processing and analyzing scientific images with the ImageJ program. In this observational, prospective, non-randomized study, 148 eyes of 74 patients with a mean age of 30.7 ± 8.5 years (ranging from 23 to 61 years) were assessed. All patients underwent a complete ophthalmological examination including slit lamp, fundus oculi, ocular biometry, corneal tomography and spectral domain (SD) OCT evaluations of the foveal region in the enhanced depth imaging (EDI) mode. OCT images at two different brightness levels were obtained. The total choroidal area (TCA), choroidal vascularity index (CVI), stromal choroidal area (SCA) and luminal choroidal area (LCA) at both lower and higher brightness levels were measured. To avoid the bias of operator-dependent error, the lower and higher brightness TCAs were obtained using two methods: the manual tracking mode and fixed area. At the two different brightness levels, LCA, SCA and CVI measurements showed statistically significant changes (p < 0.05), whereas the TCA differences were not statistically significant (p > 0.05). According to the results of this study, highlighting that brightness could affect LCA, SCA and CVI parameters, care should be taken during OCT image acquisition.

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Changes in choroidal imaging parameters following adalimumab therapy for refractory noninfectious uveitis

Cited by 5 publications

References 31 publications

Immunosuppressive therapy for Vogt-Koyanagi-Harada disease: a retrospective study and review of literature

Immunosuppressive therapy for Vogt-Koyanagi-Harada disease: a retrospective study and review of literature

Artificial Intelligence and Imaging Processing in Optical Coherence Tomography and Digital Images in Uveitis

Impact of Brightness on Choroidal Vascularity Index

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