Development and Evaluation of Diagnostic Criteria for Vogt-Koyanagi-Harada Disease

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Abstract

To our knowledge, a set of well-defined diagnostic criteria is not yet developed for the diagnosis of Vogt-Koyanagi-Harada (VKH) disease.

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A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes.

Ron Margolis, Richard Spaide (2009)

To measure macular choroidal thickness in normal eyes at different points using enhanced depth imaging (EDI) optical coherence tomography (OCT) and to evaluate the association of choroidal thickness and age. Retrospective, observational case series. EDI OCT images were obtained in patients without significant retinal or choroidal pathologic features. The images were obtained by positioning a spectral-domain OCT device close enough to the eye to acquire an inverted image. Seven sections were obtained within a 5 x 30-degree area centered at the fovea, with 100 scans averaged for each section. The choroid was measured from the outer border of the retinal pigment epithelium to the inner scleral border at 500-microm intervals of a horizontal section from 3 mm temporal to the fovea to 3 mm nasal to the fovea. Statistical analysis was performed to evaluate variations of choroidal thickness at each location and to correlate choroidal thickness and patient age. The mean age of the 30 patients (54 eyes) was 50.4 years (range, 19 to 85 years), and 14 patients (46.7%) were female. The choroid was thickest underneath the fovea (mean, 287 microm; standard deviation, +/- 76 microm). Choroidal thickness decreased rapidly in the nasal direction and averaged 145 microm (+/- 57 microm) at 3 mm nasal to the fovea. Increasing age was correlated significantly with decreasing choroidal thickness at all points measured. Regression analysis suggested that the subfoveal choroidal thickness decreased by 15.6 microm for each decade of life. Choroidal thickness seems to vary topographically within the posterior pole. The thickness of the choroid showed a negative correlation with age. The decrease in the thickness of the choroid may play a role in the pathophysiologic features of various age-related ocular conditions.

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Choroidal thickness in healthy Chinese subjects.

Volkhart M-J Li, Jing Zeng, Xiaoyan Ding … (2010)

To study posterior choroidal thickness and its profile based on location in a healthy Chinese population and to determine its correlation with age and refractive error. A total of 210 healthy volunteers (420 eyes) with no ophthalmic disease history were recruited. Choroidal scans were obtained for all eyes using enhanced depth imaging spectral-domain optical coherence tomography. Subfoveal choroidal thickness (SFCT) and choroidal thickness at 1 mm/3 mm temporal, nasal, superior, and inferior to the fovea were measured. The choroid was thickest underneath the fovea (261.93 ± 88.42 μm). At 1 mm and 3 mm to the fovea, the choroid temporally was thicker than nasally. Mean SFCT in subjects younger than 60 years of age were 294.63 ± 75.90 μm, and no correlation between SFCT and age was noted. Mean SFCT in subjects older than 60 years of age was 196.52 ± 74.42 μm, much thinner than that for subjects younger than 60 years of age. A significant negative correlation was found between SFCT and age in subjects older than 60 years of age. Age is critical for evaluation of choroidal thickness. However, SFCT has no correlation with age in subjects younger than 60 years of age. In subjects older than 60 years of age, SFCT was significantly negatively correlated with age, and decreased by 5.40 μm for each year of life.

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Subfoveal choroidal thickness after treatment of Vogt-Koyanagi-Harada disease.

Hiroshi Oyamada, Tomohiro Iida, Tetsuju Sekiryu … (2011)

To evaluate the subfoveal choroidal thickness in Vogt-Koyanagi-Harada (VKH) disease using enhanced depth imaging optical coherence tomography. Retrospective observational study. Subfoveal choroidal thickness was measured using enhanced depth imaging optical coherence tomography, in which the optical coherence tomography instrument was placed close enough to the eye to obtain an inverted image, which was averaged for 100 scans. All patients were diagnosed as having the ocular findings of VKH disease with or without extraocular disorders. The patients were followed during their initial treatment with corticosteroids. All 8 patients (16 eyes) with acute phase VKH disease presented with thickening of the choroid. The serous retinal detachment disappeared in 1 month after corticosteroid treatment. The mean choroidal thickness in 16 eyes decreased from 805 ± 173 μm at the first visit to 524 ± 151 μm at 3 days (P < 0.001) and 341 ± 70 μm by 2 weeks (P < 0.001). Patients with active VKH disease have markedly thickened choroids, possibly related not only to inflammatory infiltration but also to increased exudation. Both the choroidal thickness and the exudative retinal detachment decreased quickly with corticosteroid treatment. Enhanced depth imaging optical coherence tomography can be used to evaluate the choroidal involvement in VKH disease in the acute stages and may prove useful in the diagnosis and management of this disease noninvasively.

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Author and article information

Journal

Title: JAMA Ophthalmology

Abbreviated Title: JAMA Ophthalmol

Publisher: American Medical Association (AMA)

ISSN (Print): 2168-6165

Publication date Created: September 01 2018

Publication date (Print): September 01 2018

Volume: 136

Issue: 9

Page: 1025

Affiliations

[1 ]The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, Chongqing, People’s Republic of China

[2 ]State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People’s Republic of China

[3 ]The Eye and ENT Hospital of Fudan University, Shanghai, People’s Republic of China

[4 ]Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China

[5 ]Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China

[6 ]Department of Ophthalmology, Beijing Chao-Yang Hospital of Capital Medical University, Beijing, People’s Republic of China

[7 ]Department of Ophthalmology, Peking University First Hospital, Beijing, People’s Republic of China

[8 ]Department of Ophthalmology, Ningxia People’s Hospital, Yinchuan, People’s Republic of China

[9 ]Department of Ophthalmology, the Second Xiangya Hospital of Central South University, Changsha, People’s Republic of China

[10 ]Department of Ophthalmology, the First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China

[11 ]Department of Ophthalmology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China

[12 ]Department of Ophthalmology, the Second Hospital of Anhui Medical University, Hefei, People’s Republic of China

[13 ]Tianjin Medical University Eye Hospital, Tianjin, People’s Republic of China

[14 ]The Eye Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China

[15 ]Department of Ophthalmology, Shenzhen Children’s Hospital, Shenzhen, People’s Republic of China

[16 ]Shenzhen Eye Hospital, Shenzhen Key Ophthalmic Laboratory, the Second Affiliated Hospital of Jinan University, Shenzhen, People’s Republic of China

[17 ]Department of Ophthalmology, Jinling Hospital, Medical School of Nanjing University, Nanjing, People’s Republic of China

[18 ]Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Zhengzhou, People’s Republic of China

[19 ]Department of Ophthalmology, Xi’an No. 4 Hospital, Xi’an, People’s Republic of China

[20 ]Ophthalmic Center of the Second Hospital, Jilin University, Changchun, People’s Republic of China

[21 ]Department of Ophthalmology, the Second People’s Hospital of Jinan City, Jinan, People’s Republic of China

[22 ]Shanxi Eye Hospital, Taiyuan, People’s Republic of China

[23 ]College of Information Engineering, Xiangtan University, Xiangtan, People’s Republic of China

[24 ]University Eye Clinic Maastricht, Maastricht, Limburg, the Netherlands

Article

DOI: 10.1001/jamaophthalmol.2018.2664

PMC ID: 6142975

PubMed ID: 29978190

SO-VID: 49045486-9e85-4a03-a02e-20fd78a0ae7c

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Development and Evaluation of Diagnostic Criteria for Vogt-Koyanagi-Harada Disease

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Most cited references 20

A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes.

Choroidal thickness in healthy Chinese subjects.

Subfoveal choroidal thickness after treatment of Vogt-Koyanagi-Harada disease.

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