Diagnostic Function of 3D Optical Coherence Tomography Images in Diagnosis of Vogt-Koyanagi-Harada Disease at Acute Uveitis Stage

Abstract

BackgroundThis study analyzed the macular 3D-OCT images of Vogt-Koyanagi-Harada disease (VKH) in uveitis, explored the characteristics of 3D-OCT images of the macular region of VKH, and assessed which characteristics contribute most to VKH diagnosis.Material/MethodsThe 3D-OCT examination of 25 cases of VKH was performed on the macular area, and the image characteristics were analyzed.ResultsOur study included a total of 50 eyes from 25 cases of VKH patients, 10 males and 15 females, aged 17 to 64 years, mean (39.44±11.60) years old. According to OCT B-scan images, 49 (98%) eyes had ERD, 49 (98%) eyes had nerve retinal edema, 36 (72%) eyes had endometrium-like structure (including cysts), 5 (10%) eyes had RPE folds, 35 (70%) eyes had changes in the internal septum, 49 (98%) eyes had RPE monolayer structure outside the ERD region. In ILM-RPE thickness, 49 (98%) eyes had retinal irregular thickening and 31 (62%) eyes had radial stripe changes. In ILM contour figure, 50 eyes (100%) showed exceptional uplift, 5 (10%) eyes had small focal uplift for PED on the RPE surface, and 48 (96%) eyes had wavy ups and downs.ConclusionsIn OCT B-scan imaging, the ERT, retinal edema of the retina, and the RPE monolayer structure outside the range are most likely to occur in VKH. The ILM-RPE thickness chart in 3D reconstruction showed irregular thickening of the retina. The ILM contour graph showed abnormal uplift, and RPE surface wavy ups and downs in VKH most likely to occur.

Diagnostic Function of 3D Optical Coherence Tomography Multimode Images in Diagnosis of Acute Central Serous Chorioretinopathy

“…FI was found in OCT of VKH before (21,33). Our previous studies of VKH also found FI, and speculated that there is a certain relationship with retinal Radial stripes (34). Dusheng et al (21) speculated that FI was associated with in ammation.…”

Outcomes of Retinal Pigment Epithelial Detachment in Vogt-Koyanagi-Harada Disease

“…On OCT, uctuations of ILM, subretinal septa, subretinal membranous structures and hyperre ective dots, bulge of RPE, folds of RPE, and resultant high RPE undulation index are characteristics of VKH. However, isolated serous PED always points to CSC because of its high prevalence in CSC, and it is regarded as an intermediate stage between pachychoroid and classic CSC [11][12][13][14][15]. Meanwhile, mechanical disruption at the RPE level is the most plausible factor responsible for generating the focal leakage points in CSC [16].…”

“…The uid within the PED applies pressure to the RPE and stretches it, the PED enlarges as the pressure increases, which will add angulation and mechanical stress to the base of the PED and may weaken or rupture the RPE layer [28]. PED was observed in 0-10% of eyes with acute VKH disease, according to several cross-sectional OCT-based studies [14,[11][12][13]29]. Conversely, PED with or without associated ERD has been reported to occur in 44.2-100% of eyes with CSC [11,13,12,15].…”

Biológiai terápia szisztémás alkalmazása a szemészetben

“…rológiai vagy bőrpanaszok társulnak. Feltételezett VKHbetegség esetén uveitis extraocularis manifesztáció nélkül alakul ki [5,6]. A VKH-szindróma adekvát terápiáját az akut fázisban alkalmazott kortikoszteroidok jelentik, melyet a későbbi stádiumokban immunmoduláns kezelés válthat fel [6].…”

“…Feltételezett VKHbetegség esetén uveitis extraocularis manifesztáció nélkül alakul ki [5,6]. A VKH-szindróma adekvát terápiáját az akut fázisban alkalmazott kortikoszteroidok jelentik, melyet a későbbi stádiumokban immunmoduláns kezelés válthat fel [6]. Betegünk azonban immunszuppresszív kezelésre rezisztensnek bizonyult, a szteroidot a gyulladásos tünetek fellángolása nélkül nem tudtuk 20 mg alá csökkenteni, így az új kezelési lehetőséget, a TNFα-gátló adalimumabterápiát választottuk.…”