Brief report
Choroidal Folds in Vogt-Koyanagi-Harada Disease

https://doi.org/10.1016/j.ajo.2006.11.050Get rights and content

Purpose

To analyze choroidal folds in Vogt-Koyanagi-Harada (VKH) disease by fluorescein angiography (FA), indocyanine green angiography (ICGA), and optical coherence tomography (OCT).

Design

Retrospective, consecutive case series.

Methods

Records of 95 patients diagnosed with VKH disease from October 2001 to July 2006 were reviewed. All patients underwent FA, 17 patients underwent ICGA, and 20 underwent OCT.

Results

Of the 95 patients, 11 (12.0%) had choroidal folds and showed 10 to 15 hypofluorescent bands radiating from the optic disk that were similar to the large retinal vessels in shape and number on FA. On ICGA, the choroidal folds showed hyperfluorescence at the late stage. OCT showed clear folds but the number of folds was larger than on FA and ICGA.

Conclusions

Choroidal folds are not uncommon in VKH disease. FA, ICGA, and OCT can help to identify their pathogenesis.

References (6)

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    Choroidal inflammation is thought to be the main pathophysiologic mechanism by which choroidal thickening occurs in eyes with VKH. The thickening is likely related to both inflammatory infiltration and increased exudation21 and can result in accompanying structural changes. For example, previous studies have reported focal hyper-reflectivity loss in the inner choroid in eyes with either acute- or convalescent-phase VKH.26

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    Gupta et al.66 demonstrated RPE undulations in 4 patients with bilateral VKH, with RPE troughs corresponding to choroidal striations, and hyperreflective dots over RPE peaks corresponding to pinpoint hyperfluorescence on FA. They hypothesized that choroidal inflammation and congestion resulted in the RPE undulations, in agreement with previous reports.67,68 Both the RPE undulations and choroidal striations resolved with steroid therapy.

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