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      Changes of Peripapillary Capillary Density in Patients with Vogt–Koyanagi–Harada Disease Evaluated by Optical Coherence Tomography Angiography


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          To analyze the longitudinal changes in peripapillary capillary density in patients with acute VKH with or without optic disc swelling by optical coherence tomography angiography (OCTA).


          Retrospective case series. 44 patients (88 eyes) were enrolled and were divided into two groups according to presence/absence of optic disc swelling before treatment. Peripapillary capillary images were obtained by OCTA before and after 6 months of corticosteroid treatment and used to determine the radial peripapillary capillary (RPC), retinal plexus, and choriocapillaris vessel perfusion densities.


          Optic disc swelling was present in 12 patients (24 eyes) and absent in 32 patients (64 eyes). The sex distribution, age, intraocular pressure, and best-corrected visual acuity before and after treatment were not significantly different between the two groups (all P > 0.05). Compared to those in nonoptic disc swelling group, the percentages of decreased vessel perfusion densities after treatment in the supranasal (RPC, 100.00% vs. 75.00%), infranasal (RPC, 100.00% vs. 56.25%), infratemporal (RPC, 66.67% vs. 37.50%), and infranasal quadrants (retinal plexus, 83.33% vs. 56.25%) were significantly more in optic disc swelling group. The choriocapillaris vessel perfusion density increased after treatment in both groups.


          Decreases in vessel perfusion densities of the RPC and retinal plexus after treatment in VKH patients with optic disc swelling were more common than in those without optic disc swelling. The choriocapillaris vessel perfusion density increased after treatment, regardless of the presence/absence of optic disc swelling.

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          Most cited references28

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          Vogt-Koyanagi-Harada disease.

          Vogt-Koyanagi-Harada disease, a severe bilateral granulomatous intraocular inflammation associated with serous retinal detachments, disk edema, and vitritis, with eventual development of a sunset glow fundus, is an autoimmune inflammatory condition mediated by T cells that target melanocytes in individuals susceptible to the disease. Vogt-Koyanagi-Harada disease presents clinically in 4 different phases: prodromal, uveitic, convalescent, and recurrent, with extraocular manifestations including headache, meningismus, hearing loss, poliosis, and vitiligo, to varying degrees. There have been considerable advances in imaging modalities resulting in earlier diagnosis and improved understanding of this disease. Ocular coherence tomography has replaced other imaging modalities in the diagnosis of acute and chronic Vogt-Koyanagi-Harada disease by revealing exudative detachments of the retina in the acute stage, along with choroidal thickening and demonstrating choroidal thinning in the chronic stage. Treatment of this disease is initially with corticosteroids, with a transition to immunomodulatory drugs for long-term control. Patients with Vogt-Koyanagi-Harada disease can have good final outcomes if treated promptly and aggressively and thus avoid complications such as sunset glow fundus, cataracts, glaucoma, subretinal fibrosis, and choroidal neovascularization.
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            Development and Evaluation of Diagnostic Criteria for Vogt-Koyanagi-Harada Disease

            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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              Radial Peripapillary Capillary Network Visualized Using Wide-Field Montage Optical Coherence Tomography Angiography.

              We quantitatively analyzed the features of a radial peripapillary capillary (RPC) network visualized using wide-field montage optical coherence tomography (OCT) angiography in healthy human eyes.

                Author and article information

                J Ophthalmol
                J Ophthalmol
                Journal of Ophthalmology
                17 April 2023
                : 2023
                : 1271070
                1Department of Ophthalmology, Shanghai Xuhui Central Hospital, Shanghai 200031, China
                2Department of Laboratory, Shanghai Xuhui Central Hospital, Shanghai 200031, China
                3Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai 200031, China
                Author notes

                Academic Editor: Enrico Peiretti

                Author information
                Copyright © 2023 Zhijian Jiang et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                : 2 December 2022
                : 24 March 2023
                : 3 April 2023
                Research Article

                Ophthalmology & Optometry
                Ophthalmology & Optometry


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