Chinese Medical Sciences Journal ›› 2012, Vol. 27 ›› Issue (1): 29-34.doi: 10.1016/S1001-9294(12)60019-4

• Original Article • Previous Articles     Next Articles

Spectral Domain Optical Coherence Tomography of Vogt-Koyanagi-Harada Disease: Novel Findings and New Insights into the Pathogenesis

Chan Zhao, Mei-fen Zhang*, Fang-tian Dong, Xu-qian Wang, Xin Wen, Rong-ping Dai, Wei-hong Yu, Zhi-qiao Zhang, Zhi-kun Yang, and Fei Gao   

  1. Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  • Received:2011-11-29 Revised:2012-04-01 Published:2012-03-30 Online:2012-03-30

ObjectiveTo provide novel spectral domain optical coherence tomography (SD OCT) findings of Vogt-Koyanagi-Harada (VKH) disease as well as new insights into the pathogenesis of this disease. Methods Detailed SD OCT and fluorescein angiography (FA) findings of 18 consecutive VKH patients (11 women and 7 men) from December 2007 to April 2009 who were in acute uveitic stage at presentation were reviewed. All the patients had been followed up for at least 6 months with reevaluation(s) of SD OCT performed in 10 patients. Results Intraretinal cysts were found to be located in various layers of the outer retina. In addition to the photoreceptor layer, t hey could also be found between the outer plexiform layer and the outer nuclear layer, or spanning the external limiting membrane. On FA, intraretinal cysts could be hypofluorescent, normofluorescent, or hyperfluorescent. Some intraretinal cysts had a characteristic FA pattern, in which a small round hypofluorescent area was surrounded by a ring of hyperfluorescence (donut-shaped dye pooling). Subretinal fibrinoid deposit appeared in acute uveitic stage in two severe VKH patients and seemed to develop from subretinal exudates and evolved into typical subretinal fibrosis. Gradual transfiguration/migration and progressive proliferation/pigmentation of the subretinal fibrinoid deposit/subretinal fibrosis was observed in one patient. Conclusions Intraretinal cysts could form in various layers of the outer retina and may result from extension of choroidal inflammation. Subretinal fibrosis may develop from subretinal exudates in VKH patients and may cause substantial visual impairment.

Key words: Vogt-Koyanagi-Harada disease, spectral domain optical coherence tomography, fluorescein angiography, subretinal fibrosis, intraretinal cysts

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