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Choroidal circulation impairment during the anterior recurrence of Vogt–Koyanagi–Harada disease confirmed with indocyanine green angiography and laser speckle flowgraphy
Author(s) -
Takemoto Yuko,
Namba Kenichi,
Mizuuchi Kazuomi,
Iwata Daiju,
Uno Tomoe,
Ohno Shigeaki,
Hirooka Kiriko,
Hashimoto Yuki,
Saito Wataru,
Sugiyama Kazuhisa,
Ishida Susumu
Publication year - 2016
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.13024
Subject(s) - vogt–koyanagi–harada disease , medicine , indocyanine green angiography , indocyanine green , ophthalmology , optic disc , surgery , visual acuity , fluorescein angiography , uveitis , retinal
Purpose To assess choroidal inflammation‐related circulatory changes associated with the anterior recurrence of Vogt–Koyanagi–Harada ( VKH ) disease, using indocyanine green angiography ( ICGA ) and laser speckle flowgraphy ( LSFG ). Methods This retrospective case series included 17 eyes of 11 patients with VKH disease showing recurrent inflammatory findings in the anterior, but not posterior, segment (i.e. anterior recurrence). Indocyanine green angiography (ICGA) and LSFG were performed at the time of recurrence and one month after the initiation of corticosteroid therapy. The number and total area of hypofluorescent dark dots ( HDD s) on ICGA were independently counted by three physicians and measured with ImageJ, respectively. Mean blur rate ( MBR ), a quantitative index of relative blood flow velocity, was calculated via the LSFG Analyzer software. Results Hypofluorescent dark dots (HDDs) were identified on ICGA in 13 of 17 eyes (76%) with the anterior recurrence of VKH disease. The number and total area of HDD s significantly decreased from 203 ± 101 dots to 59 ± 51 dots and from 48 789 ± 24 251 pixels to 15 664 ± 13 254 pixels, respectively. The change ratio of MBR significantly increased by 17.9 ± 16.3% after the treatment. Importantly, there was no significant association between the change ratios of HDD s and MBR . Conclusions These findings on LSFG and ICGA clearly demonstrated subclinical involvement as well as post‐treatment improvement of choroidal circulation impairment due to granulomatous inflammation in eyes with the anterior recurrence of VKH disease. The present data suggest the validity of using these two examinations, capable of detecting different circulatory changes, in the management of recurrent VKH disease.