Observation of acute Vogt-Koyanagi-Harada disease in spectral domain optical coherence tomography
YUE Yankun1, LIU Wu2, and MO Bin2.
1. Department of Ophthalmology, Beijing Fuxing Hospital Affiliated to Capital Medical University, Beijing 100038,China.
2.Department of Ophthalmology, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing 100730, China
Abstract:Objective To observe retinal morphology in fundus and the pathognomonic internal structure of acute Vogt-Koyanagi-Harada syndrome (VKH syndrome) by spectral domain optical coherence tomography (SD-OCT) (Cirrus; Carl Zeiss Meditec, Inc.). Methods Data on 40 eyes of 20 cases of acute stage of VKH syndrome were collected from Beijing Tongren Hospital. All the patients underwent careful examination, including visual acuity, slit-lamp microscopy, indirect ophthalmoscopy, fundus fluorescein angiography, with Cirrus OCT using 512×128 cube scan pattern and HD-5 cube scan pattern. Main indexes were the qualitative description the specific changes in the internal structure of OCT retinal posterior pole. Results HD-OCT showed that 12 eyes (30%) had edema of optic disc bulge, 34 eyes (85%) had posterior pole retinal detachment, six of which (15%) had simple retinal detachment. The other 28 eyes (70%) showed split inside and outside the photoreceptor cell section (IS/OS) layer in the central fovea of macula, formation of cysts (cystoid space CS), presence of granular reflected signal in CS, the photoreceptor cell layer of the outer segment (OS) layer close to the retinal pigment epithelium (RPE), and a layer of uniformly thick film-like structure. Conclusions Acute Vogt-Koyanagi-Harada syndrome does not cause retinal detachment alone; retinal IS / OS splitting occurs only in the central fovea of macula.