Elevated choroidal blood flow velocity during systemic corticosteroid therapy in Vogt–Koyanagi–Harada disease

Abstract

. Purpose: Laser speckle flowgraphy (LSFG) can be used to non‐invasively visualize the haemodynamics of choroidal circulation and the vascular pattern. The purpose of this study was to examine the ability of LSFG to quantitatively evaluate blood flow velocity at the macula in patients with Vogt–Koyanagi–Harada (VKH) disease before and after systemic corticosteroid therapy. Methods: Prednisolone (200 mg/day) was systemically administered in 10 VKH disease patients with serous retinal detachment at the macular area. The drug was gradually tapered to zero over a 6‐month period. Laser speckle flowgraphy measurements were taken in the 20 eyes of these patients at their initial visit and at 1, 4 and 12 weeks after the onset of therapy. Square blur rate (SBR), a quantitative index of relative blood flow velocity, was calculated using LSFG. Results: Serous retinal detachment resolved within 4 weeks after treatment and visual acuities improved to > 1.0 in almost all cases. There were significant increases in average SBR at the macula at 4 weeks after treatment compared with at 1 week after treatment, and also at 12 weeks after treatment compared with at 4 weeks after treatment. Conclusions: These results suggest that systemic corticosteroid therapy improves inflammation‐related impairment in choroidal blood flow velocity at the macula. Laser speckle flowgraphy can evaluate the effect of systemic corticosteroid therapy by enabling comparisons between measurements of blood flow velocity, which is considered to reflect inflammation activity in the choroid.

Spectral-Domain-Optical Coherence Tomography in Uveitis

“…Whereas local choroidal blood flow increased and the integrity of the outer retinal hyperreflective bands improved over time, the choroidal thickness and reflectivity findings noted initially remained unchanged. The authors noted that such choroidal changes have not been reported in patients with AMN, but are consistent with acute choroidal inflammation seen in other setting, including both VKH disease 23 and serpiginous choroiditis.…”

Pulse Waveform Changes in Macular Choroidal Hemodynamics With Regression of Acute Central Serous Chorioretinopathy

“…The macular MBR, largely derived from the choroid, 16 has been used to evaluate choroidal hemodynamics in various diseases. [17][18][19][20][21][22][23][24][25][26] Our recent study on CSC demonstrates that the macular MBR increases at the acute stage, 19 reinforcing the suspected role of choroidal hyperperfusion in the development of acute CSC. 10 With recent advances of LSFG, various parameters can be automatically calculated to analyze the pulse waveform of MBR averaged in a single heartbeat, 14,[27][28][29][30][31] including the skew, blowout time (BOT), and acceleration time index (ATI), all of which are expressed as absolute values.…”

Decreased choroidal blood flow velocity in the pathogenesis of multiple evanescent white dot syndrome

“…Recently, laser speckle flowgraphy (LSFG) has been used to investigate ocular blood flow velocity [7][8][9][10][11][12][13]. The wavelength of 830 nm for a diode laser used in LSFG can penetrate deep into the choroid, as demonstrated in composite color map images depicting the large choroidal vessels.…”