ENHANCED DEPTH IMAGING OPTICAL COHERENCE TOMOGRAPHY OF THE CHOROID IN VOGT-KOYANAGI-HARADA DISEASE

Purpose: Optical coherence tomography (OCT) using enhanced depth imaging (EDI) allows evaluation of choroidal thickness. Our objective was to analyze subfoveal choroidal thickness by EDI-OCT before and after the initiation of high-dose corticosteroid treatment in 8 patients (16 eyes) with new-onset acute Vogt-Koyanagi-Harada (VKH) disease. Methods: Retrospective review of clinical records. Results: The outer border of the choroid was not evident by EDI-OCT in any patients at presentation. Subfoveal choroidal thickness was measurable by 1 week after the initiation of treatment (mean, 578 mu m) and decreased thereafter (mean at 1 month, 397 mu m; 3 months, 392 mu m; 6 months, 384 mu m; 12 months, 332 mu m). Rebound of choroidal thickening was observed in three patients (five eyes) during corticosteroid tapering in the absence of other evidence of increased inflammation. Peripapillary atrophy was present at 12 months in 6 of 6 eyes that had a choroidal thickness > 550 mu m at 1 week after initiating treatment, in contrast to none of the 8 eyes with a choroidal thickness <= 550 mu m (P = 0.0003). Conclusion: Enhanced depth imaging-optical coherence tomography revealed decreasing choroidal thickness with high-dose corticosteroid treatment in our patients. Choroidal thickness as measured by EDI-OCT may serve as a marker for degree of choroidal inflammation in acute VKH disease. RETINA 32: 2061-2069, 2012