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Correlation between Retinal Changes and Visual Function in Late-Stage Vogt-Koyanagi-Harada Disease: An Optical Coherence Tomography Study.

Zhou M, Jiang C, Gu R, Sun Z, Huynh N, Chang Q - J Ophthalmol (2015)

Bottom Line: These effects included RPE thickening and breakage or disappearance of the cone outer segment tip (COST) line and/or inner segment/outer segment (IS/OS) junction.The COST line and IS/OS results were related to macular function and the interval between symptom onset and initiation of high-dose corticosteroid treatment (all P < 0.01).Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Fenyang Road 83, Xuhui District, Shanghai 200031, China ; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, China.

ABSTRACT
Purpose. To characterize the optical coherence tomography (OCT) findings in late-stage Vogt-Koyanagi-Harada (VKH) disease and its correlation with visual function. Methods. The records of patients with late-stage VKH disease (defined as ≥12 months from disease onset) were retrospectively reviewed. The analysis focused on the OCT findings and microperimetry, in addition to the possible correlation between morphology and functional findings. Results. Twenty-nine patients (58 eyes) were included. Mean age at onset was 34.24 ± 10.67 years. The OCT revealed that the outer retina and retinal pigment epithelium (RPE) were mainly affected. These effects included RPE thickening and breakage or disappearance of the cone outer segment tip (COST) line and/or inner segment/outer segment (IS/OS) junction. The COST line and IS/OS results were related to macular function and the interval between symptom onset and initiation of high-dose corticosteroid treatment (all P < 0.01). Eyes with intact COST lines demonstrated intact IS/OS and normal RPE layers as well as better visual function and normal retinal sensitivity. Conclusions. The OCT findings are strongly correlated with macular function, as well as other clinical findings in late-stage VKH. With respect to the COST line and retinal sensitivity especially, the OCT and microperimetry findings may be useful for evaluating later-stage VKH.

No MeSH data available.


Related in: MedlinePlus

Standards for OCT grading: (a) intact COST line (arrowheads) and junction between the photoreceptor inner and outer segments (IS/OS) line (arrows) with normal RPE layer; (b) discontinuous COST lines (arrowheads) and intact IS/OS line (arrows); (c) discontinuous COST line (arrowheads) and IS/OS line (arrows); and (d) thickened RPE layer (asterisk).
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fig1: Standards for OCT grading: (a) intact COST line (arrowheads) and junction between the photoreceptor inner and outer segments (IS/OS) line (arrows) with normal RPE layer; (b) discontinuous COST lines (arrowheads) and intact IS/OS line (arrows); (c) discontinuous COST line (arrowheads) and IS/OS line (arrows); and (d) thickened RPE layer (asterisk).

Mentions: The OCT findings in the late-stage VKH eyes were localized to the outer retina. The findings included thickening of the RPE layer (28/58 eyes); breakage or disappearance of the COST line (51/58 eyes) and/or the inner segment/outer segment (IS/OS) junction (28/58 eyes); and thinning of the outer nuclear layer (ONL) (17/58 eyes). The grading of the RPE, COST line, and IS/OS conjunction is listed in Table 2. Notably, all eyes displaying intact COST lines also displayed intact IS/OS junctions and normal RPE layers. However, 23 of the 30 eyes displaying intact IS/OS junctions displayed fragmented (Grade 1, 3 eyes; Grade 2, 20 eyes) COST lines. In 18 of the 51 eyes displaying fragmented COST lines (Grade 1 or 2) and in 16 of the 28 eyes displaying fragmented IS/OS junctions (Grade 1 or 2), the central fovea remained intact (Figures 1(a)–1(c)).


Correlation between Retinal Changes and Visual Function in Late-Stage Vogt-Koyanagi-Harada Disease: An Optical Coherence Tomography Study.

Zhou M, Jiang C, Gu R, Sun Z, Huynh N, Chang Q - J Ophthalmol (2015)

Standards for OCT grading: (a) intact COST line (arrowheads) and junction between the photoreceptor inner and outer segments (IS/OS) line (arrows) with normal RPE layer; (b) discontinuous COST lines (arrowheads) and intact IS/OS line (arrows); (c) discontinuous COST line (arrowheads) and IS/OS line (arrows); and (d) thickened RPE layer (asterisk).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4537757&req=5

fig1: Standards for OCT grading: (a) intact COST line (arrowheads) and junction between the photoreceptor inner and outer segments (IS/OS) line (arrows) with normal RPE layer; (b) discontinuous COST lines (arrowheads) and intact IS/OS line (arrows); (c) discontinuous COST line (arrowheads) and IS/OS line (arrows); and (d) thickened RPE layer (asterisk).
Mentions: The OCT findings in the late-stage VKH eyes were localized to the outer retina. The findings included thickening of the RPE layer (28/58 eyes); breakage or disappearance of the COST line (51/58 eyes) and/or the inner segment/outer segment (IS/OS) junction (28/58 eyes); and thinning of the outer nuclear layer (ONL) (17/58 eyes). The grading of the RPE, COST line, and IS/OS conjunction is listed in Table 2. Notably, all eyes displaying intact COST lines also displayed intact IS/OS junctions and normal RPE layers. However, 23 of the 30 eyes displaying intact IS/OS junctions displayed fragmented (Grade 1, 3 eyes; Grade 2, 20 eyes) COST lines. In 18 of the 51 eyes displaying fragmented COST lines (Grade 1 or 2) and in 16 of the 28 eyes displaying fragmented IS/OS junctions (Grade 1 or 2), the central fovea remained intact (Figures 1(a)–1(c)).

Bottom Line: These effects included RPE thickening and breakage or disappearance of the cone outer segment tip (COST) line and/or inner segment/outer segment (IS/OS) junction.The COST line and IS/OS results were related to macular function and the interval between symptom onset and initiation of high-dose corticosteroid treatment (all P < 0.01).Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Fenyang Road 83, Xuhui District, Shanghai 200031, China ; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, China.

ABSTRACT
Purpose. To characterize the optical coherence tomography (OCT) findings in late-stage Vogt-Koyanagi-Harada (VKH) disease and its correlation with visual function. Methods. The records of patients with late-stage VKH disease (defined as ≥12 months from disease onset) were retrospectively reviewed. The analysis focused on the OCT findings and microperimetry, in addition to the possible correlation between morphology and functional findings. Results. Twenty-nine patients (58 eyes) were included. Mean age at onset was 34.24 ± 10.67 years. The OCT revealed that the outer retina and retinal pigment epithelium (RPE) were mainly affected. These effects included RPE thickening and breakage or disappearance of the cone outer segment tip (COST) line and/or inner segment/outer segment (IS/OS) junction. The COST line and IS/OS results were related to macular function and the interval between symptom onset and initiation of high-dose corticosteroid treatment (all P < 0.01). Eyes with intact COST lines demonstrated intact IS/OS and normal RPE layers as well as better visual function and normal retinal sensitivity. Conclusions. The OCT findings are strongly correlated with macular function, as well as other clinical findings in late-stage VKH. With respect to the COST line and retinal sensitivity especially, the OCT and microperimetry findings may be useful for evaluating later-stage VKH.

No MeSH data available.


Related in: MedlinePlus