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Vogt‐Koyanagi‐Harada disease : why indocyanine green angiography‐assisted therapy is going to become the standard of care
Author(s) -
BOUCHENAKI N,
HERBORT C
Publication year - 2011
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/j.1755-3768.2011.2245.x
Subject(s) - medicine , vogt–koyanagi–harada disease , indocyanine green angiography , subclinical infection , ophthalmology , indocyanine green , lesion , fundus (uterus) , fluorescein angiography , fundus photography , surgery , radiology , uveitis , visual acuity , pathology
Purpose To assess the potential of ICGA in the monitoring of treatment of acute Vogt‐Koyanagi‐Harada (VKH) disease by detecting early recurrences. Methods Retrospective/prospective study including patients in the initial acute phase of VH disease treated early with high dose inflammation suppressive therapy who were followed by indocyanine green angiography. (ICGA) at regular intervals. Results The angiographic characteristics of ICGA in VKH in acute phase include hypofluorescent dark dots, fuzzy leaking choroidal vessels in the early and intermediate angiographic phase followed by diffuse choroidal hypperfluorescence in the late phase, and in very severe inflammation disc hyperfluorescence and pinpoints with subretinal fluid can be seen. All those signs disappear with early and intensive anti‐inflammatory therapy. ICGA was effective in objectively detecting recurrence in apparently controlled disease by showing re‐appearence of choroidal lesions (mainly dark dots) before biomicroscopy or fluorescein angiography manifestations, allowing early and fine adjustement of treatment during tapering period. Conclusion By detecting subclinical choroidal inflammatory lesions ICGA allows detection of subtle recurrent lesion and refine therapeutic adjustement in order to avoid evolution toward chronic form and prevent sunset glow fundus.