The Role of Widefield Optical Coherence Tomography Angiography in the Diagnosis and Management of Acute Vogt–Koyanagi–Harada Disease

We explore the choroid vasculature changes of acute Vogt–Koyanagi–Harada (VKH) disease using widefield optical coherence tomography angiography (OCTA).
In this retrospective, observational, longitudinal study, 16 patients with acute VKH disease (32 eyes, mean age: 42.19 ±13.66 years) were measured using widefield OCTA.
In this study, we first described the multiple dark foci in choriocapillaris and Sattler’s layer in the panoramic montage of the five 12x12mm images in 30 eyes (93.8%) of acute VKH disease. OCTA follow-up in these 30 eyes demonstrated the diminished size and number of these dark foci in choriocapillaris and Sattler’s layer after the initiation of treatment.
Widefield OCTA enables noninvasive identification of characteristics of flow void at the level of superficial choroidal vessels in the acute phase and may be a novel valuable tool for diagnosis and monitoring of disease progression in VKH disease in the future.

本研究采用广角光学相干断层扫描血管成像（widefield optical coherence tomography angiography, OCTA）技术，探究急性伏格特-小柳-原田病（Vogt–Koyanagi–Harada, VKH）的脉络膜血管改变。
本研究为回顾性观察性纵向研究，共纳入16例急性VKH病患者（共32只眼，平均年龄42.19±13.66岁），均接受广角OCTA检查。
本研究首次在30只急性VKH病患眼（占比93.8%）的五张12×12mm扫描图像拼接而成的全景图像中，观察到脉络膜毛细血管层（choriocapillaris）与萨特勒层（Sattler’s layer）存在多发暗灶。对上述30只患眼的OCTA随访结果显示，启动治疗后，上述脉络膜毛细血管层与萨特勒层内的暗灶尺寸与数量均有所减少。
广角OCTA可无创识别急性发病期脉络膜浅层血管的血流缺失特征，未来或可成为诊断与监测VKH病病情进展的新型有效工具。