Diagnostic Value of Optical Coherence Tomography in the Early Diagnosis of Macular Complications in Chronic Vogt-Koyanagi-Harada Disease

Agarwal, Mamta; Radosavljević, Aleksandra; Patnaik, Gazal; Rishi, Ekta; Pichi, Francesco

doi:10.1080/09273948.2020.1833225

Cited by 8 publications

(2 citation statements)

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“…Chronic VKH is often characterized by a sunset glow fundus, and it occurs after 2-6 months. Among patients with chronic VKH, 38% progress to subretinal fibrosis [50][51][52][53]. Mild inflammation often persists, even when systemic steroid therapy is properly administered in the early stage of onset, and after the inflammation seems to be resolved.…”

Section: Description Of Initial-onset and Chronic Vkh Diseasementioning

confidence: 99%

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Vogt-Koyanagi-Harada disease: the step-by-step approach to a better understanding of clinicopathology, immunopathology, diagnosis, and management: a brief review

Urzua

Herbort²,

Takeuchi

et al. 2022

J Ophthal Inflamm Infect

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Background Appraisals of Vogt-Koyanagi-Harada disease (VKH) have become progressively more complete, since its first description in 1906. The availability of new investigational methods has improved our knowledge of the immunopathology, clinicopathology, diagnosis, and management of VKH disease. This review aimed to describe some of the steps that led to better characterization of VKH as a clinical entity. Methods We searched on PubMed for articles that described the history of VKH disease and analyzed the progress in disease appraisal with new investigational and imaging methods. In particular, we searched for articles that investigated the clinicopathology, diagnosis, and management of VKH. Findings The following developments were considered essential for improving the appraisal and understanding of VKH: (1) the history of the disease, (2) immunopathological mechanisms, (3) clinicopathology, (4) the importance of distinguishing initial-onset from chronic disease, (5) relevant imaging modalities, among which indocyanine green angiography is crucial, (6) diagnostic criteria that facilitate early diagnosis, and (7) the need for early, prolonged, aggressive treatment that combines steroidal and non-steroidal immunosuppression. Conclusion Based on these findings, the definition of VKH has improved. VKH disease starts in the choroidal stroma and later involves other structures when it is not diagnosed and treated early. Indocyanine green angiography and enhanced depth imaging optical coherence tomography facilitate early diagnosis and precise monitoring of choroidal inflammation. ICGA is clearly the gold standard for appraisals and follow-ups in VKH disease, however EDI-OCT should be especially considered in those areas where ICGA is not fully available. These modalities have contributed substantially to a “cure” for VKH, when treatment is introduced within the therapeutic window of opportunity.

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Section: Description Of Initial-onset and Chronic Vkh Diseasementioning

confidence: 99%

“…In chronic VKH, SD-OCT could show signs of subclinical inflammation, such as macular edema and early signs of macular complications [52]. Regardless of the specific OCT findings, the most practical aspect of SD-OCT is its ability to provide close monitoring of lesion remission after (aggressive) treatment.…”

Section: Retinal Sd-octmentioning

confidence: 99%